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South Dakota rates for HCPCS 0657T

Anterior lumbar or thoracolumbar vertebral body tethering; 8 or more vertebral segments

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $4,365.16 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,187.76 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $3,548.13 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $3,311.31 / $16,982.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,467.37 / $6,309.57