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South Dakota rates for HCPCS 15273

Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Facilitymedian $302 · 10th–90th $182–$4,3650%10%20%10th90th$302Professionalmedian $302 · 10th–90th $178–$5890%10%10th90th$302$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
$181.97 / $302.00 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $416.87
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $537.03 / $870.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $407.38 / $794.33
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $588.84 / $3,801.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $691.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $575.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $467.74 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $398.11 / $724.44
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $416.87 / $660.69