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South Dakota rates for HCPCS 20931

Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $5,248.07 / $10,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $177.83 / $295.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $245.47 / $245.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $190.55 / $213.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83