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South Dakota rates for HCPCS Q4141

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

Facilitymedian $107 · 10th–90th $93–$1120%50%10th90th$107Professionalmedian $107 · 10th–90th $48–$1260%50%10th90th$107$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
$107.15 / $107.15 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $45.71 / $47.86
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $114.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $251.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $77.62 / $77.62
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $204.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
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
$107.15 / $107.15 / $107.15
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15