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South Dakota rates for HCPCS Q4128

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

Facilitymedian $30 · 10th–90th $29–$43,6520%50%10th90th$30Professionalmedian $29 · 10th–90th $29–$370%50%90th$29$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
$28.84 / $28.84 / $43,651.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $37.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $51.29 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $29.51 / $30.90
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $51.29 / $63.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $30.90 / $134.90
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $37.15 / $37.15
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $169.82 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $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