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South Dakota rates for HCPCS 14301

Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm

Facilitymedian $1,660 · 10th–90th $832$8,1280%10%10th90th$1,660Professionalmedian $1,072 · 10th–90th $407$2,5120%10%10th90th$1,072$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$831.76 / $1,659.59 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,023.29 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$54.95 / $169.82 / $169.82
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,737.80 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,511.89 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,412.54 / $2,818.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,137.96 / $7,943.28
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,995.26 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $2,238.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,778.28 / $2,089.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,698.24 / $2,754.23
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,905.46 / $2,344.23