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South Dakota rates for HCPCS 15842

Graft for facial nerve paralysis; free muscle flap by microsurgical technique

Facilitymedian $3,467 · 10th–90th $2,570–$4,5710%20%10th90th$3,467Professionalmedian $4,074 · 10th–90th $2,455–$6,7610%10%10th90th$4,074$2.0K$5.0K$10.0K$20.0K

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
$2,570.40 / $2,570.40 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,570.40 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $6,165.95 / $7,585.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,715.35 / $6,456.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,786.30 / $19,952.62
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $6,165.95 / $6,165.95
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $5,248.07
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,365.16 / $5,248.07
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
$2,511.89 / $4,466.84 / $7,079.46
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $5,888.44