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South Dakota rates for HCPCS 31755

Tracheoplasty; tracheopharyngeal fistulization, each stage

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $3,090.30 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,949.84 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $4,073.80 / $5,128.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $2,511.89 / $4,466.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $3,090.30 / $12,882.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,801.89 / $3,981.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,548.13 / $3,548.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,884.03 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,388.44 / $4,786.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $3,801.89 / $3,890.45