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South Dakota rates for HCPCS 15241

Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $170 · 10th–90th $98–$4,3650%10%20%10th90th$170Professionalmedian $182 · 10th–90th $98–$3720%10%10th90th$182$100.0$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
$97.72 / $169.82 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $158.49 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $380.19 / $501.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $213.80 / $436.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $363.08 / $1,905.46
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $251.19 / $416.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $371.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $338.84
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
$128.82 / $223.87 / $457.09
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $371.54