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South Dakota rates for HCPCS Q4156

Neox 100 or Clarix 100, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $66 · 10th–90th $65–$1320%50%10th90th$66Professionalmedian $66 · 10th–90th $65–$1510%50%10th90th$66$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
$64.57 / $64.57 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $112.20 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $77.62 / $83.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $112.20 / $181.97
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $66.07 / $3,981.07
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $79.43 / $79.43
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
$151.36 / $151.36 / $151.36
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
$66.07 / $66.07 / $66.07
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07