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South Dakota rates for HCPCS 27557

Open Tx Knee Dislocation W/Ligamentous Repair

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.76 / $1,023.76 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.12 / $1,023.76 / $2,485.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,776.35 / $2,312.37 / $2,890.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,350.06 / $1,759.56 / $2,743.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.52 / $2,083.81 / $8,230.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,542.08 / $2,366.28 / $3,235.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,542.08 / $2,270.00 / $2,806.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,267.86 / $1,758.01 / $2,046.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.52 / $2,042.80 / $2,860.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,030.50 / $2,484.40 / $2,484.40