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SurgiGRAFT-DUAL

South Dakota rates for HCPCS Q4219

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

Rates data updated July 2026.

How much does SurgiGRAFT-DUAL cost?

$891

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $891 for this service. The price depends on where it is billed: about $851 from a physician practice, and about $891 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$851$182 to $1,023
FacilityA hospital or hospital-owned outpatient department$891$891 to $1,202

How much rates vary

Facilitymedian $891 · 10th to 90th $245 to $1,660Professionalmedian $851 · 10th to 90th $148 to $1,202
$200$500$1K$2K$5Kfacility $891professional $851

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Aetna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,023.29
Typical High
$1,202.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$181.97
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$1,621.81
Typical High
$2,041.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$4,570.88
Midlands
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$204.17
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$851.14
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25

Where South Dakota sits

The same service costs 8.1 times more in Rhode Island than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 43rd of 51

$891

RI $1,023NC $126

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.