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South Dakota rates for HCPCS 23174

Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $3,090.30 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $758.58 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,778.28 / $2,238.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,288.25 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,258.93 / $7,244.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,698.24 / $1,698.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,659.59
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,288.25 / $1,513.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,348.96 / $2,089.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,778.28 / $1,862.09