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South Dakota rates for HCPCS 19368

Breast Reconstruction 1pedicled Tram Flap Anast

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,049.76 / $2,049.76 / $2,049.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,784.97 / $2,049.76 / $6,293.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,755.42 / $4,801.59 / $6,001.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,552.51 / $3,464.09 / $5,781.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,584.90 / $4,308.16 / $24,606.41
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,345.04 / $5,270.83 / $6,696.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,510.00 / $4,755.42 / $5,814.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,734.07 / $3,668.02 / $4,226.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,584.90 / $4,308.16 / $6,040.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,873.80 / $4,557.50 / $4,739.80