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South Dakota rates for HCPCS 28171

Rad Rescj Tumor Tarsal Except Talus/Calcaneus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,087.63 / $1,087.63 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.43 / $1,087.63 / $2,641.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,793.22 / $2,466.63 / $3,083.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,094.96 / $1,552.20 / $2,308.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$985.01 / $1,952.06 / $8,142.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,339.82 / $2,520.87 / $3,711.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,133.00 / $1,916.37 / $2,974.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,048.19 / $1,622.94 / $2,176.82
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
$985.01 / $2,038.10 / $3,036.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,159.50 / $2,642.20 / $2,642.20