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South Dakota rates for HCPCS 22857

Total Disc Arthrp Ant Single Interspace Lumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,725.39 / $1,725.39 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,433.98 / $1,647.81 / $2,757.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,959.58 / $3,852.65 / $4,815.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,059.91 / $2,735.23 / $4,666.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,674.76 / $3,623.03 / $13,625.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,677.96 / $3,929.88 / $5,450.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,495.00 / $3,437.16 / $4,735.50
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,181.10 / $2,990.93 / $3,418.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $6,571.00 / $6,571.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,897.78 / $3,450.50 / $4,839.68
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,391.00 / $4,149.00 / $4,149.00