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South Dakota rates for HCPCS Q4257

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

Facilitymedian $912 · 10th–90th $759–$1,0960%50%10th90th$912Professionalmedian $912 · 10th–90th $501–$1,1480%50%10th90th$912$100.0$200.0$500.0$1.0K$2.0K

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
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $758.58 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $630.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,096.48 / $1,659.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $645.65 / $3,630.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $776.25 / $776.25
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
$1,412.54 / $1,412.54 / $1,412.54
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
$912.01 / $912.01 / $912.01
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01