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South Dakota rates for HCPCS 25170

Radical Resection Tumor Radius Or Ulna

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,437.12 / $1,437.12 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,210.08 / $1,437.12 / $3,494.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,499.34 / $3,253.52 / $4,066.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.60 / $2,239.10 / $3,841.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,306.50 / $3,000.08 / $10,766.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,216.10 / $3,312.13 / $4,535.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,815.52 / $3,068.56 / $3,939.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,486.29 / $2,482.10 / $2,878.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,571.47 / $3,000.08 / $4,022.76
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,855.10 / $3,493.40 / $3,493.40