go back

South Dakota rates for HCPCS 28002

I&D Below Fascia Foot 1 Bursal Space

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.71 / $253.52 / $253.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.71 / $350.45 / $652.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.05 / $527.84 / $704.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.77 / $422.14 / $997.39
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.78 / $1,035.17 / $2,614.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$351.70 / $749.02 / $1,969.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.87 / $749.02 / $1,035.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.51 / $400.88 / $738.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.65 / $635.04 / $1,253.64
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.20 / $330.60 / $572.40