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South Dakota rates for HCPCS Q4166

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

Facilitymedian $20 · 10th–90th $19–$350%50%10th90th$20Professionalmedian $21 · 10th–90th $19–$280%20%40%10th90th$21$20.0$50.0$100.0$200.0

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
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $23.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $33.88 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $25.12 / $27.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $35.48 / $41.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $20.89 / $91.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $25.70
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
$22.39 / $22.39 / $22.39
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
$19.95 / $19.95 / $19.95
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95