go back

South Dakota rates for HCPCS 28645

Open Tx Metatarsophalangeal Joint Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.64 / $663.21 / $663.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$438.29 / $590.85 / $977.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.50 / $1,405.30 / $1,874.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$599.15 / $834.18 / $1,533.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.35 / $1,529.35 / $4,876.64
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,081.51 / $1,423.58 / $3,711.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.42 / $1,244.06 / $1,729.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.72 / $961.29 / $1,265.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.60 / $1,307.54 / $1,859.26
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$953.60 / $1,166.80 / $1,535.90