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South Dakota rates for HCPCS 24900

Amputation Arm Thru Humerus W/Primary Closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.25 / $733.25 / $733.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.47 / $733.25 / $1,834.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,331.66 / $1,733.50 / $2,166.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$945.81 / $1,239.19 / $1,885.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$716.22 / $1,489.68 / $5,479.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.21 / $1,688.09 / $2,292.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.21 / $1,529.02 / $1,983.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.72 / $1,228.76 / $1,516.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.81 / $1,302.39 / $2,025.94
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,504.30 / $1,840.50 / $1,840.50