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South Dakota rates for HCPCS 23335

Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,246.61 / $1,246.61 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,508.40 / $1,998.80 / $3,340.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,925.60 / $2,873.04 / $3,913.75
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,578.07 / $2,133.98 / $2,485.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00