go back

South Dakota rates for HCPCS 20805

Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,167.88 / $3,167.88 / $3,167.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,665.32 / $3,167.88 / $7,727.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,494.23 / $7,152.14 / $8,940.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,828.73 / $5,353.72 / $8,494.45
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,025.64 / $6,367.18 / $27,142.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,726.76 / $7,420.04 / $10,047.70
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,726.76 / $6,208.04 / $8,719.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,882.01 / $5,488.69 / $6,355.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $6,571.00 / $6,571.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,335.19 / $6,063.98 / $8,916.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,305.20 / $7,714.60 / $7,714.60