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South Dakota rates for HCPCS 24201

Removal Foreign Body Upper Arm/Elbow Deep

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.86 / $563.48 / $563.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.87 / $529.34 / $967.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$754.28 / $1,157.94 / $1,778.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.40 / $808.72 / $1,432.39
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.63 / $1,246.79 / $4,568.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$820.31 / $1,246.79 / $2,824.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$754.28 / $968.00 / $1,399.16
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.48 / $802.16 / $1,204.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.74 / $998.37 / $1,527.68
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.80 / $973.60 / $1,462.00