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South Dakota rates for HCPCS 15272

Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $25 · 10th–90th $15–$4,3650%10%20%10th90th$25Professionalmedian $25 · 10th–90th $15–$520%10%10th90th$25$20.0$50.0$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
$15.14 / $22.91 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $21.88 / $32.36
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $19.05 / $33.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $46.77 / $70.79
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $33.11 / $70.79
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $53.70 / $3,801.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $39.81 / $60.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $53.70
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $38.90 / $46.77
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
$20.42 / $35.48 / $66.07
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $36.31 / $52.48