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South Dakota rates for HCPCS 30901

Control Nasal Hemorrhage Anterior Simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.91 / $169.97 / $372.66
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$461.35 / $461.35 / $461.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.28 / $94.83 / $426.60
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$66.75 / $75.53 / $651.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.32 / $152.90 / $449.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.93 / $150.88 / $343.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.12 / $312.56 / $1,154.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.06 / $174.14 / $496.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.78 / $174.14 / $356.50
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.93 / $157.81 / $301.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.59 / $258.30 / $401.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.10 / $127.40 / $352.10