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South Dakota rates for HCPCS 28755

Arthrodesis Great Toe Interphalangeal Joint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.06 / $518.03 / $518.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.05 / $734.07 / $1,188.50
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$773.58 / $1,169.97 / $8,250.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.29 / $665.66 / $982.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00