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South Dakota rates for HCPCS 15277

Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, 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 $331 · 10th–90th $209–$4,3650%10%20%10th90th$331Professionalmedian $339 · 10th–90th $200–$6920%10%10th90th$339$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
$208.93 / $331.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $288.40 / $457.09
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $616.60 / $977.24
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $426.58 / $870.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $645.65 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $524.81 / $758.58
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $630.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $512.86 / $660.69
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
$263.03 / $467.74 / $794.33
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $478.63 / $741.31