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South Dakota rates for HCPCS 28304

Osteotomy, tarsal bones, other than calcaneus or talus;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.66 / $843.29 / $843.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$877.58 / $1,190.96 / $1,930.91
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,271.52 / $1,814.40 / $8,250.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$888.71 / $1,214.23 / $1,612.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$304.86 / $304.86 / $304.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00