go back

South Dakota rates for HCPCS Q4200

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$999.03 / $999.03 / $999.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$999.03 / $1,688.36 / $2,737.34