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South Dakota rates for HCPCS 25685

Open Tx Trans-Scaphoperilunar Fracture Dislc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.44 / $733.44 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$618.22 / $733.44 / $1,450.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,280.79 / $1,667.27 / $2,084.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$960.93 / $1,218.68 / $1,917.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.91 / $1,494.36 / $5,464.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,099.02 / $1,811.87 / $8,250.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,099.02 / $1,526.83 / $1,979.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$906.55 / $1,242.22 / $1,461.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.91 / $1,297.19 / $2,017.85
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,449.70 / $1,773.80 / $1,773.80