go back

South Dakota rates for HCPCS 15958

Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.83 / $1,122.83 / $1,122.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,393.25 / $1,771.82 / $3,063.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,917.00 / $2,862.25 / $3,929.20
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.50 / $1,954.69 / $2,277.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00