go back

South Dakota rates for HCPCS 15100

Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)

Facilitymedian $1,413 · 10th–90th $676–$3,0900%20%10th90th$1,413Professionalmedian $955 · 10th–90th $646–$1,7380%10%20%10th90th$955$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
$676.08 / $2,884.03 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $794.33 / $1,202.26
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,412.54 / $2,398.83
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,479.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,995.26 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,202.26 / $2,187.76
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,698.24 / $6,456.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,621.81 / $1,949.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $1,778.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,412.54 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,380.38 / $2,187.76
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,548.82 / $1,905.46