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South Dakota rates for HCPCS 25300

Tenodesis Wrist Flexors Fingers

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$692.88 / $692.88 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.71 / $692.88 / $1,665.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,211.35 / $1,576.90 / $1,971.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$905.33 / $1,167.42 / $1,781.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.11 / $1,391.67 / $5,145.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,089.00 / $1,705.72 / $3,711.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,021.70 / $1,423.83 / $1,859.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.80 / $1,162.69 / $1,377.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $6,489.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.97 / $1,214.28 / $1,888.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,366.30 / $1,671.70 / $1,671.70