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South Dakota rates for HCPCS 23397

Muscle Transfer Shoulder/Upper Arm Multiple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.59 / $1,122.59 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$946.33 / $1,122.59 / $2,714.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.91 / $2,538.31 / $3,172.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,359.40 / $1,855.48 / $2,984.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,108.15 / $2,323.46 / $8,602.26
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,932.00 / $2,786.41 / $8,250.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,714.20 / $2,379.37 / $3,039.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,397.26 / $1,913.50 / $2,237.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,108.15 / $2,008.40 / $3,124.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,219.80 / $2,716.00 / $2,716.00