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South Dakota rates for HCPCS 25392

Osteoplasty, radius AND ulna; shortening (excluding 64876)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,002.47 / $1,002.47 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$844.00 / $1,002.47 / $2,425.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,745.82 / $2,272.63 / $2,840.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.23 / $1,724.70 / $2,651.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,085.07 / $2,093.62 / $7,482.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,542.37 / $2,440.04 / $8,250.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,542.37 / $2,122.39 / $2,727.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,232.09 / $1,700.84 / $2,000.86
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
$1,085.07 / $1,844.38 / $2,775.95
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,984.90 / $2,428.60 / $2,428.60