go back

South Dakota rates for HCPCS 27558

Open Tx Knee Dislocation W/Repair/Reconstruction

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,162.35 / $1,162.35 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.44 / $1,162.35 / $2,826.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,015.75 / $2,624.01 / $3,280.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,534.45 / $1,964.39 / $3,130.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,206.83 / $2,431.42 / $9,637.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,798.18 / $2,696.08 / $3,678.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,798.18 / $2,571.44 / $3,192.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,471.79 / $2,006.33 / $2,326.25
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
$1,273.59 / $2,141.96 / $3,256.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,307.69 / $2,823.60 / $2,823.60