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South Dakota rates for HCPCS 15240

Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less

Facilitymedian $1,288 · 10th–90th $776–$6,4570%10%10th90th$1,288Professionalmedian $1,047 · 10th–90th $724–$1,9950%10%10th90th$1,047$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
$776.25 / $933.25 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $851.14 / $1,412.54
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,621.81 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,187.76 / $2,754.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,230.27 / $2,187.76
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,819.70 / $6,918.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,819.70 / $2,137.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,905.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,548.82 / $1,819.70
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
$812.83 / $1,445.44 / $2,511.89
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,659.59 / $2,041.74