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South Dakota rates for HCPCS 0622T

Trabeculostomy ab interno by laser; with use of ophthalmic endoscope

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.80 / $302.80 / $302.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.18 / $302.80 / $314.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.18 / $449.81 / $861.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.74 / $512.17 / $915.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$378.51 / $509.43 / $754.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.47 / $465.68 / $1,418.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.05 / $463.44 / $898.83