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South Dakota rates for HCPCS 27455

Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); before epiphyseal closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.96 / $953.96 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$802.06 / $953.96 / $2,294.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,657.25 / $2,157.33 / $2,696.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,250.99 / $1,573.12 / $2,460.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.57 / $1,918.41 / $7,097.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.98 / $2,131.00 / $2,985.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.98 / $1,962.23 / $2,579.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,165.81 / $1,604.53 / $1,894.12
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
$1,004.88 / $1,905.64 / $2,609.66
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,879.00 / $2,299.10 / $2,299.10