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South Dakota rates for HCPCS Q4158

Kerecis Omega3, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $95 · 10th–90th $68–$2,5120%20%40%10th90th$95Professionalmedian $68 · 10th–90th $66–$850%50%10th90th$68$5.0$20.0$100.0$500.0$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
$67.61 / $2,454.71 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $5.01 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $75.86 / $81.28
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
$63.10 / $66.07 / $776.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $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
$85.11 / $85.11 / $85.11
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
$67.61 / $67.61 / $67.61
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61