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South Dakota rates for HCPCS 25023

Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; with debridement of nonviable muscle and/or nerve

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $3,548.13 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $2,137.96 / $3,019.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,511.89 / $2,570.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,905.46 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28