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Dermacyte Amniotic Membrane Allograft

South Dakota rates for HCPCS Q4248

Dermacyte Amniotic Membrane Allograft, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Dermacyte Amniotic Membrane Allograft cost?

$692

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $692 for this service. The price depends on where it is billed: about $692 from a physician practice, and about $550 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$692$550 to $1,318
FacilityA hospital or hospital-owned outpatient department$550$550 to $2,818

How much rates vary

Facilitymedian $550 · 10th to 90th $550 to $4,786Professionalmedian $692 · 10th to 90th $550 to $2,818
$200$500$1K$2K$5K$10Kfacility $550professional $692

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
$549.54
Median
$549.54
Typical High
$549.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$1,513.56
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,412.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$4,786.30
Typical High
$5,011.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$2,818.38
Typical High
$9,332.54
Midlands
Setting
Professional
Modifier
Global
Typical Low
$3,388.44
Median
$3,388.44
Typical High
$3,388.44
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
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54

Where South Dakota sits

The same service costs 2.7 times more in South Dakota than in Minnesota. 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· 1st of 51

$692

SD $692MN $257

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.