go back

South Dakota rates for HCPCS 27258

Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc);

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,096.48 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,570.40 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $1,862.09 / $2,884.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,819.70 / $8,709.64
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,511.89 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $2,398.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,862.09 / $2,187.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,995.26 / $3,019.95
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,570.40 / $2,630.27