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South Dakota rates for HCPCS 30915

Ligation arteries; ethmoidal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$643.28 / $643.28 / $3,073.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.83 / $643.28 / $1,596.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.60 / $1,371.22 / $1,714.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$693.83 / $1,006.53 / $1,510.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$675.06 / $1,125.09 / $4,509.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$935.00 / $1,548.44 / $3,013.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$947.00 / $1,318.05 / $1,640.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$685.77 / $980.72 / $1,171.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$675.06 / $1,211.25 / $1,629.49
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.00 / $1,313.00 / $1,365.50