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South Dakota rates for HCPCS 25316

Flexor Origin Slide F/Arm&/Wrst Tendon Transfe

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.90 / $908.90 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$765.72 / $908.90 / $2,217.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.23 / $2,062.28 / $2,577.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,192.71 / $1,584.64 / $2,381.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.94 / $1,857.43 / $7,097.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.94 / $2,373.17 / $8,250.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,367.94 / $2,038.57 / $2,466.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,127.05 / $1,540.27 / $1,811.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.94 / $1,768.98 / $2,507.29
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,797.50 / $2,199.30 / $2,199.30