go back

South Dakota rates for HCPCS 25628

Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $9,332.54 / $13,489.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,202.26 / $1,862.09
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,621.81 / $1,621.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,230.27 / $1,445.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$275.42 / $275.42 / $275.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $5,370.32