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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.

How much does Restorigin cost?

$724

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $724 for this service. The price depends on where it is billed: about $724 from a physician practice, and about $661 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$724$661 to $1,023
FacilityA hospital or hospital-owned outpatient department$661$661 to $1,230

How much rates vary

Facilitymedian $661 · 10th to 90th $661 to $1,445Professionalmedian $724 · 10th to 90th $661 to $1,479
$200$500$1K$2K$5Kfacility $661professional $724

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where South Dakota sits

The same service costs 2.8 times more in Wisconsin than in Minnesota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 2nd of 51

$724

WI $724MN $257

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.