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South Dakota rates for HCPCS Q4188

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

Facilitymedian $490 · 10th–90th $490–$8320%50%90th$490Professionalmedian $490 · 10th–90th $398–$8320%50%10th90th$490$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
$489.78 / $489.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $977.24 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $501.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $831.76 / $977.24
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $2,398.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
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
$831.76 / $831.76 / $831.76
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
$489.78 / $489.78 / $489.78
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78