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South Dakota rates for HCPCS 12051

Repair Intermediate F/E/E/N/L&/Muc 2.5 Cm/<

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.44 / $283.49 / $611.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.84 / $250.02 / $711.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.17 / $483.04 / $816.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.71 / $392.37 / $669.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.17 / $602.05 / $2,106.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.51 / $441.64 / $724.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.00 / $492.79 / $759.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.97 / $390.19 / $545.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.62 / $490.66 / $763.25
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.39 / $370.00 / $611.50