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South Dakota rates for HCPCS 14041

Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$736.26 / $905.14 / $1,959.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.44 / $879.78 / $1,508.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,585.21 / $2,137.85 / $2,672.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$926.24 / $1,336.23 / $2,361.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.17 / $2,323.60 / $6,899.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,471.64 / $1,913.58 / $2,416.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,469.00 / $1,903.36 / $2,451.63
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,027.58 / $1,491.75 / $1,810.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,022.38 / $1,662.95 / $2,586.81
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,367.20 / $1,672.80 / $2,029.70