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South Dakota rates for HCPCS 33875

Descending thoracic aorta graft, with or without bypass

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.11 / $2,754.11 / $2,754.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,550.42 / $2,754.11 / $2,754.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,338.14 / $5,660.16 / $7,075.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,656.62 / $4,310.21 / $7,216.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,866.15 / $5,308.54 / $19,402.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,472.00 / $6,137.02 / $8,330.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,458.00 / $5,868.95 / $7,260.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,434.59 / $4,575.51 / $5,216.60
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
$2,866.15 / $5,211.18 / $7,287.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,380.70 / $6,330.20 / $6,583.40