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South Dakota rates for HCPCS Q4116

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

Facilitymedian $15,488 · 10th–90th $33–$52,4810%20%10th90th$15,488Professionalmedian $26 · 10th–90th $25–$400%50%10th90th$26$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$14,791.08 / $15,488.17 / $52,480.75
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.70 / $30.90
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $33.11 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $53.70 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $38.90 / $39.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $41.69 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $169.82 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $125.89 / $239.88