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South Dakota rates for HCPCS 49904

Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)

Facilitymedian $1,778 · 10th–90th $1,259–$4,3650%20%10th90th$1,778Professionalmedian $2,291 · 10th–90th $1,698–$2,8840%10%20%10th90th$2,291$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
$1,258.93 / $1,258.93 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,089.30 / $3,715.35
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,162.28 / $3,162.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,238.72 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26