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South Dakota rates for HCPCS 22614

Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.12 / $361.12 / $2,290.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.36 / $632.80 / $1,019.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$576.35 / $861.46 / $1,202.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.52 / $667.26 / $760.75
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$146.96 / $146.96 / $146.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$146.96 / $146.96 / $146.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00