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South Dakota rates for HCPCS 28495

Cltx Fx Grt Toe Phlx/Phlg W/Manj

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.84 / $163.80 / $309.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.68 / $436.24 / $545.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.75 / $412.84 / $1,377.92
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.47 / $347.32 / $468.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.99 / $299.38 / $364.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.03 / $319.64 / $503.22
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.60 / $369.00 / $442.90