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AmnioArmor

South Dakota rates for HCPCS Q4188

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

Rates data updated July 2026.

Facilitymedian $490 · 10th–90th $490$8320%50%90th$490Professionalmedian $490 · 10th–90th $398$8320%20%40%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
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$537.03
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$501.19
Medica
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$831.76
Typical High
$977.24
Medica
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$2,398.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$588.84
Midlands
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$204.17
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78