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South Dakota rates for HCPCS 11971

Removal Tissue Expander W/O Insertion Implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$531.32 / $4,197.95 / $7,791.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$419.12 / $786.48 / $1,399.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$727.51 / $1,260.24 / $2,197.38
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.16 / $786.34 / $1,090.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00