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South Dakota rates for HCPCS 15157

Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $214 · 10th–90th $145–$4,3650%10%20%10th90th$214Professionalmedian $224 · 10th–90th $141–$3890%10%20%10th90th$224$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
$144.54 / $162.18 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $158.49 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $389.05 / $478.63
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $446.68
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $354.81 / $1,513.56
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $371.54 / $398.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $338.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $295.12 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $275.42 / $457.09
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $316.23 / $389.05