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South Dakota rates for HCPCS 28003

I&D Below Fascia Foot Multiple Areas

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.56 / $385.67 / $385.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.56 / $497.61 / $717.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.12 / $718.72 / $1,155.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$364.25 / $641.98 / $1,595.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$720.45 / $1,633.31 / $4,561.17
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$643.79 / $1,089.00 / $3,711.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.82 / $1,189.84 / $1,633.31
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.85 / $636.05 / $1,181.86
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
$489.42 / $1,272.74 / $1,986.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.80 / $605.40 / $880.20