go back

South Dakota rates for HCPCS 15005

Prep Site F/S/N/H/F/G/M/D Gt Addl 100 Sq Cm/1pct

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.37 / $110.40 / $110.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.36 / $162.19 / $323.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.05 / $240.88 / $314.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.94 / $181.95 / $226.42
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$45.30 / $45.30 / $45.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$45.30 / $45.30 / $45.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00