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South Dakota rates for HCPCS 12054

Repair Intermediate F/E/E/N/L&/Muc 7.6-12.5 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.79 / $381.43 / $381.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.66 / $332.68 / $440.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.54 / $824.42 / $1,092.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.26 / $506.83 / $944.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.57 / $888.18 / $2,838.24
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.18 / $541.13 / $1,005.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.00 / $660.37 / $1,041.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.63 / $527.64 / $737.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.80 / $710.54 / $1,048.77
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.10 / $480.90 / $827.00