go back

South Dakota rates for HCPCS 24201

Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $562.34 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $549.54 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,174.90 / $1,819.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $812.83 / $1,258.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $1,071.52 / $4,570.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $831.76 / $1,258.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $794.33 / $1,202.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $812.83 / $1,202.26
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
$457.09 / $812.83 / $1,479.11
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $977.24 / $1,445.44