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South Dakota rates for HCPCS 25420

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.93 / $1,148.93 / $1,148.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.98 / $1,148.93 / $2,784.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,000.19 / $2,603.75 / $3,254.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,511.27 / $1,977.57 / $3,050.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,240.44 / $2,368.11 / $8,810.18
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,747.06 / $3,065.81 / $10,457.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,747.06 / $2,550.39 / $3,137.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,439.71 / $1,956.43 / $2,295.85
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
$1,240.44 / $2,051.50 / $3,191.22
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,277.60 / $2,786.70 / $2,786.70