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South Dakota rates for HCPCS Q4184

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

Facilitymedian $79 · 10th–90th $79–$1580%50%90th$79Professionalmedian $79 · 10th–90th $79–$5010%50%90th$79$100.0$200.0$500.0$1.0K$2.0K

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
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $851.14 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $95.50 / $102.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $134.90 / $588.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $2,754.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
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
$501.19 / $501.19 / $501.19
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
$79.43 / $79.43 / $79.43
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43