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South Dakota rates for HCPCS Q4193

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,393.12 / $1,393.12 / $1,393.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.12 / $1,393.12 / $1,393.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,808.00 / $2,808.00 / $3,510.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,106.00 / $2,106.00 / $2,632.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,713.18 / $2,895.27 / $2,982.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,608.27 / $1,713.18 / $8,892.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,929.92 / $1,929.92 / $2,055.82
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,929.92 / $2,055.82 / $2,055.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,524.54 / $1,524.54 / $1,524.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.12 / $1,393.12 / $1,532.43
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,713.18 / $1,713.18 / $1,713.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.18 / $1,713.18 / $1,713.18