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South Dakota rates for HCPCS 15278

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; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $91 · 10th–90th $51–$4,3650%10%20%10th90th$91Professionalmedian $91 · 10th–90th $49–$1910%10%10th90th$91$50.0$100.0$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
$51.29 / $91.20 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $125.89
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $269.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $117.49 / $239.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $165.96 / $6,025.60
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $128.82 / $199.53
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $158.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $138.04 / $181.97
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
$66.07 / $117.49 / $213.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $120.23 / $204.17