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South Dakota rates for HCPCS 22515

Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.00 / $2,290.00 / $3,153.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.00 / $2,510.57 / $4,679.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.12 / $580.42 / $8,131.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.83 / $3,606.43 / $9,010.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,754.42 / $9,275.62 / $31,785.96
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$471.62 / $5,977.40 / $9,010.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.22 / $5,977.40 / $9,053.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.34 / $4,516.33 / $7,304.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,730.19 / $6,827.99 / $11,042.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.90 / $508.80 / $6,448.80