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South Dakota rates for HCPCS 14001

Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.79 / $787.58 / $787.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605.82 / $739.64 / $1,043.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,346.33 / $1,840.62 / $2,314.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$784.37 / $1,142.66 / $2,059.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$775.51 / $1,966.55 / $6,000.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,319.00 / $1,716.91 / $2,364.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.00 / $1,649.30 / $2,154.73
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$823.12 / $1,282.16 / $1,589.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$775.51 / $1,420.72 / $2,210.01
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,175.09 / $1,437.70 / $1,782.30