go back

South Dakota rates for HCPCS 33884

Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); each additional proximal extension (List separately in addition to code for primary procedure)

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.33 / $791.57 / $989.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$381.51 / $651.88 / $1,098.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.23 / $785.88 / $4,568.99
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$729.00 / $877.23 / $1,204.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$667.00 / $839.88 / $1,130.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.45 / $654.78 / $746.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.53 / $766.94 / $1,036.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$770.00 / $905.90 / $942.10