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South Dakota rates for HCPCS 33694

Compl Rpr T-Fallot W/O Pulm Atresia Tanulr Patch

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,960.63 / $1,960.63 / $1,960.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,816.16 / $1,960.63 / $2,858.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,805.40 / $4,034.96 / $5,043.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $3,313.46 / $5,109.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,046.59 / $3,772.93 / $22,284.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,441.00 / $4,579.39 / $5,961.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,385.71 / $4,187.75 / $5,187.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,435.33 / $3,264.82 / $3,722.26
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
$2,046.59 / $3,721.08 / $5,191.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,839.40 / $4,516.89 / $4,697.60