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South Dakota rates for HCPCS Q4111

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

Facilitymedian $8 · 10th–90th $7–$120%50%10th90th$8Professionalmedian $7 · 10th–90th $7–$130%50%90th$7$10.0$20.0$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
$7.08 / $7.08 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $13.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $11.48 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $8.51 / $9.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $12.02 / $14.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $32.36
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $8.51 / $9.12
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $169.82 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $15.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $125.89 / $239.88
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $7.94
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $7.94