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South Dakota rates for HCPCS 20910

Cartilage Graft Costochondral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.63 / $479.63 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$396.72 / $479.63 / $1,019.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$843.29 / $1,097.75 / $1,372.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$623.25 / $786.00 / $1,177.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.18 / $935.40 / $3,552.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.51 / $969.05 / $1,177.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.14 / $969.05 / $1,271.35
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.58 / $773.36 / $950.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.97 / $968.66 / $1,294.58
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.70 / $1,153.50 / $1,153.50