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South Dakota rates for HCPCS 42225

Palatoplasty for cleft palate; attachment pharyngeal flap

Facilitymedian $1,585 · 10th–90th $933–$4,8980%20%10th90th$1,585Professionalmedian $1,096 · 10th–90th $891–$2,3440%20%10th90th$1,096$500.0$1.0K$2.0K$5.0K$10.0K

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
$933.25 / $4,365.16 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,023.29 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,290.87 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,412.54 / $2,454.71
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,479.11 / $7,413.10
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,238.72 / $2,238.72
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $1,862.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,513.56 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,479.11 / $2,630.27
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,344.23 / $2,344.23