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South Dakota rates for HCPCS Q4110

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

Facilitymedian $66 · 10th–90th $65–$1100%50%10th90th$66Professionalmedian $66 · 10th–90th $65–$1100%50%10th90th$66$50.0$100.0$200.0

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
$64.57 / $64.57 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $77.62 / $83.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $95.50 / $117.49
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $363.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $169.82 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $114.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $125.89 / $239.88
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07