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South Dakota rates for HCPCS Q4182

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.20 / $47.20 / $47.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.11 / $47.20 / $47.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.11 / $40.11 / $40.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.20 / $66.20 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.33 / $39.33 / $179.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.33 / $7.33 / $7.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.22 / $6.22 / $6.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.33 / $39.33 / $43.26
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.10 / $6.10 / $6.10
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.10 / $6.10 / $6.10