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South Dakota rates for HCPCS 28103

Exc/Curettage Cyst/Tumor Talus/Calcaneus Algrft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.62 / $392.62 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.02 / $383.20 / $624.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$690.07 / $898.30 / $1,122.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$521.44 / $669.53 / $1,056.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$438.09 / $837.88 / $3,959.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$738.92 / $1,045.69 / $12,337.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622.29 / $857.34 / $1,034.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.69 / $652.73 / $762.05
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
$438.09 / $709.22 / $1,103.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.00 / $925.00 / $925.00