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South Dakota rates for HCPCS Q4194

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

Facilitymedian $661 · 10th–90th $661–$1,2020%50%90th$661Professionalmedian $661 · 10th–90th $661–$8710%20%40%90th$661$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
$660.69 / $660.69 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $1,174.90 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $912.01
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,202.26 / $1,288.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $724.44 / $3,801.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
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
$851.14 / $851.14 / $851.14
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
$660.69 / $660.69 / $660.69
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69