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South Dakota rates for HCPCS Q4209

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

Facilitymedian $129 · 10th–90th $129$5890%50%90th$129Professionalmedian $129 · 10th–90th $117$3470%20%40%10th90th$129$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $125.89 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $181.97
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $588.84 / $954.99
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $263.03