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South Dakota rates for HCPCS 42815

Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx

Facilitymedian $912 · 10th–90th $513–$4,8980%20%10th90th$912Professionalmedian $912 · 10th–90th $646–$1,1220%10%20%10th90th$912$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
$512.86 / $4,365.16 / $4,897.79
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $870.96 / $1,548.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $1,258.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $891.25 / $1,047.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $12,022.64