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South Dakota rates for HCPCS 0627T

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.06 / $268.06 / $2,290.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.14 / $268.06 / $268.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.92 / $402.46 / $652.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.16 / $510.94 / $2,043.68
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.69 / $535.69 / $27,201.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.69 / $371.35 / $535.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.02 / $461.14 / $717.33