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South Dakota rates for HCPCS 28635

Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $181.97 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $173.78 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $389.05 / $512.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $263.03 / $407.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $354.81 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $309.03 / $407.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $295.12 / $398.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $257.04 / $338.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $263.03 / $478.63
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $316.23 / $407.38