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South Dakota rates for HCPCS 20697

App Mltpln Uni Xtrnl Fix Strtctc Adjmt Exchange

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,951.66 / $1,951.66 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,554.92 / $1,951.66 / $3,274.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,351.21 / $4,052.10 / $5,065.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,629.88 / $2,934.11 / $5,367.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,773.39 / $4,500.26 / $13,034.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,467.01 / $3,283.23 / $4,927.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,434.94 / $3,793.68 / $4,930.07
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,448.15 / $3,119.71 / $3,538.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,643.00 / $1,643.00 / $1,643.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,773.39 / $3,535.14 / $5,839.85
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,257.50 / $3,985.70 / $3,985.70