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South Dakota rates for HCPCS 12053

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.24 / $363.12 / $921.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.27 / $314.99 / $434.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.29 / $733.34 / $1,045.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.73 / $458.63 / $887.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.26 / $853.23 / $2,702.96
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.18 / $518.80 / $952.60
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.40 / $652.83 / $984.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.01 / $500.88 / $700.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.42 / $643.17 / $1,000.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.80 / $470.80 / $785.60