go back

South Dakota rates for HCPCS 20924

Tendon Graft From A Distance

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$506.21 / $506.21 / $506.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$612.41 / $832.97 / $1,325.01
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.74 / $1,285.00 / $8,250.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$625.14 / $851.25 / $1,001.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$187.24 / $187.24 / $187.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00