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South Dakota rates for HCPCS 12052

Repair Intermediate F/E/E/N/L&/Muc 2.6-5.0 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.75 / $647.09 / $6,933.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.30 / $314.80 / $744.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$437.39 / $569.72 / $909.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.52 / $429.12 / $810.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.45 / $682.39 / $2,348.96
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$359.29 / $483.33 / $812.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$396.00 / $561.52 / $847.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.33 / $448.47 / $609.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.36 / $473.85 / $855.68
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.90 / $436.70 / $683.30