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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
$1,327.30 / $1,327.30 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,591.58 / $2,031.57 / $2,862.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,653.10 / $2,658.11 / $3,805.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,337.19 / $1,905.09 / $2,555.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00