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South Dakota rates for HCPCS 25800

Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.88 / $733.88 / $733.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$961.55 / $1,240.26 / $1,908.30
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,285.00 / $1,806.01 / $11,275.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.16 / $1,235.63 / $1,453.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$270.50 / $270.50 / $270.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $14,287.46