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South Dakota rates for HCPCS 21235

Graft Ear Crtlg Autogenous Nose/Ear

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$577.13 / $755.67 / $3,756.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$539.00 / $699.32 / $1,206.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,162.24 / $1,638.06 / $2,125.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.04 / $1,098.46 / $1,733.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.35 / $1,656.71 / $5,495.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,196.33 / $1,656.71 / $6,855.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,108.90 / $1,425.21 / $1,925.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$803.58 / $1,120.43 / $1,436.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$644.37 / $1,305.29 / $2,030.45
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,111.50 / $1,360.00 / $1,743.90