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South Dakota rates for HCPCS 12016

Simple Repair F/E/E/N/L/M 12.6cm-20.0 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.34 / $212.06 / $212.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.38 / $309.22 / $557.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.61 / $473.35 / $562.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.51 / $319.76 / $428.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00