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South Dakota rates for HCPCS 28490

Closed treatment of fracture great toe, phalanx or phalanges; without manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $147.91 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $151.36 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $354.81 / $436.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $223.87 / $346.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $295.12 / $1,096.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $288.40 / $331.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $281.84 / $331.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $245.47 / $288.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $251.19 / $398.11
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $309.03 / $346.74