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South Dakota rates for HCPCS Q4101

Apligraf, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $30 · 10th–90th $30–$550%50%90th$30Professionalmedian $31 · 10th–90th $30–$550%50%10th90th$31$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$30.20 / $30.20 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $54.95
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.90 / $32.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $52.48 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $36.31 / $38.90
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $51.29 / $60.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $2,187.76
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $169.82 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $69.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $125.89 / $239.88
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20