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South Dakota rates for HCPCS 22904

Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $3,090.30 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,023.29 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,344.23 / $2,951.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,445.44 / $2,754.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,819.70 / $7,585.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,290.87 / $2,344.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,187.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,778.28 / $2,041.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,905.46 / $2,818.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,398.83 / $2,454.71