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South Dakota rates for HCPCS 25107

Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.78 / $625.78 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$805.97 / $1,057.57 / $1,604.42
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,089.00 / $1,537.56 / $3,711.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.22 / $1,042.94 / $1,240.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00