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South Dakota rates for HCPCS 19304

Mastectomy Subcutaneous

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,155.80 / $1,225.52 / $1,531.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,012.68 / $4,012.68 / $4,012.68
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$856.58 / $856.58 / $878.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.00 / $1,088.84 / $1,114.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.66 / $956.17 / $972.16