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South Dakota rates for HCPCS Q4164

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

Facilitymedian $1,660 · 10th–90th $1,622–$2,7540%50%10th90th$1,660Professionalmedian $1,622 · 10th–90th $331–$1,8200%50%10th90th$1,622$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,621.81 / $1,621.81 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $2,238.72 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $407.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,754.23 / $2,951.21
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,659.59 / $5,888.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $1,949.84 / $1,949.84
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
$1,318.26 / $1,318.26 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $295.12
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59