go back

South Dakota rates for HCPCS 19328

Removal of intact breast implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$531.34 / $531.34 / $2,290.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,809.48 / $5,809.48 / $5,809.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.50 / $531.34 / $889.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,140.58 / $1,255.13 / $1,568.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$560.00 / $788.91 / $1,405.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.70 / $971.16 / $4,092.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$798.00 / $1,356.91 / $2,691.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.00 / $1,129.48 / $1,492.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.21 / $855.05 / $1,093.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.70 / $971.16 / $1,382.81
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.00 / $1,178.80 / $1,225.90