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South Dakota rates for HCPCS 12057

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $602.56 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $524.81 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,202.26 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $741.31 / $1,412.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $1,096.48 / $4,466.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $977.24 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $1,148.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $912.01 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $851.14 / $1,380.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $912.01 / $1,318.26