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South Dakota rates for HCPCS 22112

Prtl Exc Vrt Bdy B1y Les W/O Spi Cord 1 Sgm Thrc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,075.47 / $1,075.47 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$913.79 / $1,075.47 / $2,735.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,877.49 / $2,444.04 / $3,055.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,312.66 / $1,657.35 / $2,859.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,017.88 / $2,160.23 / $8,158.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,583.27 / $2,427.42 / $3,519.56
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,583.27 / $2,148.38 / $3,033.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,282.67 / $1,926.85 / $2,266.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.10 / $1,884.35 / $2,931.21
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,248.69 / $2,751.30 / $2,751.30