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South Dakota rates for HCPCS 15130

Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

Facilitymedian $871 · 10th–90th $575–$4,3650%10%20%10th90th$871Professionalmedian $891 · 10th–90th $550–$1,5850%10%10th90th$891$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
$575.44 / $707.95 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $660.69 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,659.59 / $2,089.30
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,000.00 / $1,819.70
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,288.25 / $5,370.32
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,318.26 / $1,584.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,380.38
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,174.90 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,096.48 / $1,737.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,288.25 / $1,584.89