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South Dakota rates for HCPCS 30115

Excision Nasal Polyp Extensive

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.27 / $505.27 / $3,073.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$403.66 / $404.93 / $763.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$976.33 / $1,074.38 / $1,342.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$454.92 / $724.06 / $1,170.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.02 / $850.04 / $3,482.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686.00 / $1,162.05 / $2,440.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.00 / $996.37 / $1,275.45
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.70 / $735.39 / $906.31
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
$510.02 / $850.04 / $1,245.02
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$863.40 / $1,015.70 / $1,056.40