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South Dakota rates for HCPCS 13133

Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.47 / $164.28 / $164.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.59 / $153.31 / $207.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.58 / $346.70 / $476.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.82 / $237.24 / $462.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.38 / $402.98 / $1,249.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.33 / $328.03 / $447.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.00 / $331.47 / $451.57
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.45 / $242.60 / $325.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.38 / $315.52 / $486.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.10 / $270.60 / $364.90