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South Dakota rates for HCPCS 28575

Closed Tx Talotarsal Joint Dislocation W/Anes

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.34 / $392.02 / $392.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.12 / $383.36 / $645.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$618.25 / $902.08 / $1,127.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.35 / $570.26 / $908.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.45 / $834.59 / $2,876.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$646.00 / $865.35 / $3,711.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533.04 / $753.26 / $978.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.07 / $604.57 / $769.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.93 / $663.68 / $1,032.39
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.70 / $837.80 / $933.60