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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
$101.79 / $4,563.60 / $5,281.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.09 / $178.83 / $289.69
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.26 / $243.02 / $339.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.08 / $188.94 / $215.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00