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South Dakota rates for HCPCS Q4151

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

Facilitymedian $135 · 10th–90th $135$2340%50%90th$135Professionalmedian $135 · 10th–90th $135$1740%50%90th$135$100.0$200.0$500.0

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
$134.90 / $134.90 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $190.55 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $173.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $234.42 / $275.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $138.04 / $630.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $165.96 / $165.96
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $239.88
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90