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South Dakota rates for HCPCS 27120

Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,276.10 / $1,276.10 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,074.36 / $1,276.10 / $3,094.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,219.84 / $2,889.68 / $3,612.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,680.11 / $2,110.08 / $3,402.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,243.04 / $2,639.43 / $9,545.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,948.54 / $2,935.61 / $4,014.92
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,948.54 / $2,712.49 / $3,488.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,604.10 / $2,181.55 / $2,550.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,243.04 / $2,283.12 / $3,551.52
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,529.80 / $3,095.30 / $3,095.30