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South Dakota rates for HCPCS 15630

Delay Flap/Sctj Flap Eyelids Nose Ears/Lips

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.36 / $458.77 / $458.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.35 / $433.12 / $766.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.28 / $996.27 / $1,345.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.22 / $661.52 / $1,184.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.92 / $1,136.13 / $3,449.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.00 / $1,049.09 / $1,913.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.71 / $903.45 / $1,234.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.78 / $677.30 / $904.37
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
$432.92 / $826.63 / $1,285.86
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.70 / $759.50 / $1,014.10