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South Dakota rates for HCPCS 28800

Amputation, foot; midtarsal (eg, Chopart type procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$528.87 / $528.87 / $528.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$701.09 / $893.79 / $1,451.69
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.84 / $1,239.57 / $1,627.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.57 / $907.27 / $1,034.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00