go back

South Dakota rates for HCPCS Q4250

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

Facilitymedian $2,951 · 10th–90th $2,884–$4,8980%50%10th90th$2,951Professionalmedian $2,951 · 10th–90th $148–$3,3110%50%10th90th$2,951$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$2,951.21 / $2,951.21 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $3,311.31
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
$2,884.03 / $4,897.79 / $5,248.07
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $10,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $3,467.37
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
$2,398.83 / $2,398.83 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $295.12
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $2,951.21
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $2,951.21