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South Dakota rates for HCPCS Q4147

Architect, Architect PX, or Architect FX, extracellular matrix, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $1,585 · 10th–90th $58–$1,5850%50%10th$1,585Professionalmedian $58 · 10th–90th $47–$1,3490%20%10th90th$58$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$57.54 / $57.54 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $48.98 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $87.10 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,584.89 / $1,584.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
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
$1,348.96 / $1,348.96 / $1,348.96
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
$1,584.89 / $1,584.89 / $1,584.89
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89