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South Dakota rates for HCPCS 15260

Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less

Facilitymedian $1,202 · 10th–90th $813–$4,3650%10%20%10th90th$1,202Professionalmedian $1,202 · 10th–90th $794–$2,2910%10%10th90th$1,202$200.0$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
$812.83 / $977.24 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $977.24 / $1,698.24
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,737.80 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,344.23 / $2,951.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,348.96 / $2,344.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,995.26 / $7,413.10
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,949.84 / $2,290.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,041.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,659.59 / $1,949.84
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
$870.96 / $1,548.82 / $2,691.53
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,778.28 / $2,187.76