go back

South Dakota rates for HCPCS 15275

Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

Facilitymedian $263 · 10th–90th $81–$4,3650%20%10th90th$263Professionalmedian $148 · 10th–90th $78–$3090%10%10th90th$148$50.0$200.0$1.0K$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
$81.28 / $2,511.89 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $117.49 / $239.88
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $186.21 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $269.15 / $467.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $213.80 / $407.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $295.12 / $3,630.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $223.87 / $354.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $323.59
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $234.42 / $309.03
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
$120.23 / $199.53 / $371.54
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $204.17 / $346.74