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South Dakota rates for HCPCS 15040

Harvest of skin for tissue cultured skin autograft, 100 sq cm or less

Facilitymedian $257 · 10th–90th $115–$4,3650%10%20%10th90th$257Professionalmedian $363 · 10th–90th $209–$5010%10%10th90th$363$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
$114.82 / $257.04 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $316.23 / $676.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $281.84 / $575.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $363.08 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26