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Exploratory Skull Opening, Upper Brain

South Dakota rates for HCPCS 61250

Drills one or more small round openings through the skull over the upper part of the brain so the surgeon can look at, sample, or drain what lies beneath. It is used on its own as an exploratory or diagnostic step, not as the doorway to a larger operation. It is performed under anesthesia in an operating room.

Rates data updated July 2026.

How much does Exploratory Skull Opening, Upper Brain cost?

$1,514

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $1,514 for this service. The price depends on where it is billed: about $1,514 from a physician practice, and about $1,862 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,514$891 to $1,905
FacilityA hospital or hospital-owned outpatient department$1,862$1,072 to $2,291

How much rates vary

Facilitymedian $1,862 · 10th to 90th $977 to $4,365Professionalmedian $1,514 · 10th to 90th $692 to $2,344
$1K$2Kfacility $1,862professional $1,514

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$4,365.16
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$1,905.46
Typical High
$2,344.23
Medica
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,348.96
Typical High
$2,238.72
Medica
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,445.44
Typical High
$6,165.95
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$1,862.09
Typical High
$1,949.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$1,778.28
Typical High
$1,778.28
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,479.11
Typical High
$1,737.80
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,659.59
Typical High
$2,187.76
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$2,089.30
Typical High
$2,137.96

Where South Dakota sits

The same service costs 8.3 times more in California than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 16th of 51

$1,514

CA $6,918KY $832

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.