go back

South Dakota rates for HCPCS 25136

Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $3,548.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $501.19 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,174.90 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $851.14 / $1,288.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $812.83 / $4,168.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,122.02 / $1,122.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,071.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $831.76 / $1,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $891.25 / $1,380.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,174.90 / $1,202.26