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South Dakota rates for HCPCS 12004

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

Facilitymedian $240 · 10th–90th $100$8710%10%10th90th$240Professionalmedian $148 · 10th–90th $69$3160%10%10th90th$148$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $281.84 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $128.82 / $316.23
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $79.43 / $141.25
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $199.53 / $380.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $173.78 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $251.19 / $1,071.52
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $169.82 / $288.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $263.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $208.93 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $173.78 / $331.13
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $288.40