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South Dakota rates for HCPCS 15220

Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less

Facilitymedian $912 · 10th–90th $589–$4,3650%10%20%10th90th$912Professionalmedian $871 · 10th–90th $562–$1,6600%10%10th90th$871$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
$588.84 / $758.58 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $707.95 / $1,023.29
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,778.28 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,023.29 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,513.56 / $5,754.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,412.54 / $1,737.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,584.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,258.93 / $1,513.56
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
$660.69 / $1,202.26 / $1,905.46
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,348.96 / $1,698.24