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South Dakota rates for HCPCS Q4169

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

Facilitymedian $2,089 · 10th–90th $2,089–$3,7150%50%90th$2,089Professionalmedian $2,089 · 10th–90th $178–$2,8180%20%40%10th90th$2,089$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$2,089.30 / $2,089.30 / $2,089.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $223.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,715.35 / $3,981.07
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $11,748.98
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
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
$2,818.38 / $2,818.38 / $2,818.38
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
$2,089.30 / $2,089.30 / $2,089.30
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30