go back

South Dakota rates for HCPCS 27412

Autologous Chondrocyte Implantation Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,614.45 / $4,338.00 / $17,229.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,359.55 / $1,656.99 / $4,356.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,808.76 / $3,656.32 / $4,570.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,952.99 / $2,671.13 / $4,331.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,599.16 / $3,366.70 / $12,090.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,993.34 / $4,357.57 / $8,461.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,486.17 / $3,447.96 / $4,421.50
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,926.41 / $2,776.26 / $3,233.21
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
$1,599.16 / $2,898.31 / $4,508.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,207.50 / $3,924.40 / $3,924.40