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South Dakota rates for HCPCS 27096

Inject Si Joint Arthrgrphy&/Anes/Steroid W/Ima

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.77 / $1,188.90 / $1,354.65
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,288.36 / $1,949.40 / $2,318.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.23 / $182.27 / $990.00
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$117.78 / $292.83 / $932.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.34 / $235.68 / $477.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.02 / $227.14 / $418.68
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,395.62 / $1,395.62 / $1,395.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.57 / $368.95 / $2,255.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.96 / $251.32 / $447.39
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.50 / $257.00 / $410.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.47 / $226.00 / $318.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.57 / $294.14 / $457.55
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.40 / $196.30 / $386.30