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South Dakota rates for HCPCS 12017

Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.86 / $138.86 / $3,073.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.26 / $138.86 / $138.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.82 / $323.33 / $404.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.83 / $244.52 / $619.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.02 / $322.35 / $2,380.89
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.58 / $375.18 / $470.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.20 / $347.17 / $451.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.65 / $260.74 / $356.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.92 / $299.86 / $412.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $320.80 / $333.70