go back

South Dakota rates for HCPCS 28120

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$499.99 / $3,773.51 / $6,059.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$713.70 / $968.15 / $1,569.66
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,045.29 / $1,550.41 / $3,711.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.71 / $976.82 / $1,299.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00