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South Dakota rates for HCPCS 25630

Cltx Carpal Bone Fx W/O Manj Each Bone

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.88 / $319.70 / $319.70
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$221.91 / $221.91 / $239.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.62 / $295.88 / $494.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.80 / $718.44 / $921.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$386.70 / $483.90 / $740.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.45 / $690.15 / $2,350.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.01 / $657.92 / $818.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.00 / $638.34 / $818.02
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.89 / $503.61 / $628.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.93 / $546.71 / $850.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.10 / $709.80 / $763.20