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South Dakota rates for HCPCS 20938

Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.23 / $169.23 / $2,290.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.70 / $296.86 / $479.62
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.32 / $405.52 / $566.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.94 / $311.50 / $355.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$69.48 / $69.48 / $69.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00