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South Dakota rates for HCPCS Q4174

PalinGen or ProMatrX, 0.36 mg per 0.25 cc

Facilitymedian $1,349 · 10th–90th $1,349–$2,0420%50%90th$1,349Professionalmedian $1,259 · 10th–90th $372–$1,4790%20%40%10th90th$1,259$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
$1,202.26 / $1,479.11 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,258.93 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $302.00 / $371.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $2,041.74 / $2,511.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $5,623.41
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,445.44
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96