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South Dakota rates for HCPCS 15570

Formation of direct or tubed pedicle, with or without transfer; trunk

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.20 / $879.49 / $879.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$865.85 / $1,268.43 / $2,300.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,464.00 / $1,913.58 / $2,415.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$923.43 / $1,426.41 / $1,769.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00