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South Dakota rates for HCPCS 12047

Repair Intermediate N/H/F/Xtrnl Gent >30.0 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$328.44 / $530.82 / $530.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.10 / $460.34 / $530.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.54 / $965.11 / $1,544.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$448.62 / $761.82 / $1,435.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$475.57 / $1,355.18 / $4,006.24
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.24 / $1,187.58 / $1,913.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.54 / $994.16 / $1,479.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.10 / $715.42 / $1,066.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$577.78 / $952.67 / $1,481.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.20 / $774.70 / $1,195.50