go back

South Dakota rates for HCPCS 25150

Partial Excision Bone Ulna

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.52 / $572.52 / $3,073.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$747.83 / $967.56 / $1,474.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.00 / $1,426.96 / $3,711.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.82 / $962.13 / $1,135.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00