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South Dakota rates for HCPCS 28202

Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $616.60 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $933.25 / $1,412.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,023.29 / $1,412.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $870.96 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53