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South Dakota rates for HCPCS Q4201

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

Facilitymedian $76 · 10th–90th $76–$1380%50%90th$76Professionalmedian $79 · 10th–90th $76–$2880%20%40%10th90th$79$100.0$200.0$500.0$1.0K

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
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $162.18 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $95.50 / $109.65
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $134.90 / $288.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $79.43 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $104.71
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
$288.40 / $288.40 / $288.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $125.89 / $239.88
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86