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Restorigin

South Dakota rates for HCPCS Q4191

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

Rates data updated July 2026.

Facilitymedian $661 · 10th–90th $661$1,4450%50%90th$661Professionalmedian $724 · 10th–90th $661$1,4790%20%10th90th$724$100.0$200.0$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
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$812.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$1,288.25
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,202.26
Medica
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,230.27
Typical High
$1,737.80
Medica
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$5,754.40
Midlands
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,122.02
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
$1,479.11
Median
$1,479.11
Typical High
$1,479.11
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69