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South Dakota rates for HCPCS 25405

Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,028.44 / $1,028.44 / $1,028.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,351.79 / $1,768.15 / $2,702.91
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,561.68 / $2,731.39 / $10,756.16
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,275.58 / $1,741.53 / $2,048.73
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$384.78 / $384.78 / $384.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00