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South Dakota rates for HCPCS 25240

Excision distal ulna partial or complete (eg, Darrach type or matched resection)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$437.28 / $437.28 / $437.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$569.61 / $739.00 / $1,110.95
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$805.89 / $1,141.68 / $3,711.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$523.87 / $720.27 / $864.91
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$158.41 / $158.41 / $158.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00