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South Dakota rates for HCPCS 33617

Rpr Complex Cardiac Anomaly Modified Fontan Px

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,180.55 / $2,180.55 / $2,180.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,020.49 / $2,180.55 / $3,182.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,235.24 / $4,490.72 / $5,613.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,106.25 / $3,414.63 / $5,660.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,268.77 / $4,182.87 / $27,293.42
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,881.00 / $5,089.84 / $6,617.82
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,764.28 / $4,653.54 / $5,758.42
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,647.57 / $3,627.96 / $4,136.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,268.77 / $4,125.04 / $5,760.52
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,266.39 / $5,019.30 / $5,220.10