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South Dakota rates for HCPCS 15775

Punch Graft Hair Transplant 1-15 Punch Grafts

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.21 / $367.73 / $367.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.70 / $317.80 / $367.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.72 / $708.01 / $1,068.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$301.23 / $526.67 / $821.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.17 / $738.70 / $2,771.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.18 / $618.92 / $918.55
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $604.15 / $883.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$368.65 / $480.99 / $731.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.12 / $661.09 / $1,028.35
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.90 / $557.79 / $819.70