go back

South Dakota rates for HCPCS 26489

Transfer/Transplant Tendon Palmar W/Graft Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$987.79 / $987.79 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$819.89 / $987.79 / $2,267.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,992.31 / $2,192.39 / $2,740.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,180.70 / $1,594.26 / $2,395.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$901.55 / $1,897.90 / $7,149.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.89 / $2,368.76 / $3,711.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.89 / $1,900.86 / $2,631.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$997.49 / $1,566.18 / $1,883.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$847.13 / $1,684.94 / $2,621.02
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,868.80 / $2,286.50 / $2,286.50