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South Dakota rates for HCPCS 28264

Capsulotomy, midtarsal (eg, Heyman type procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $891.25 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,318.26 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,737.80 / $2,290.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,348.96 / $1,737.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84