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South Dakota rates for HCPCS 33915

Pulmonary artery embolectomy; without cardiopulmonary bypass

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,393.43 / $1,393.43 / $1,393.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,285.54 / $1,393.43 / $1,393.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,703.97 / $2,867.09 / $3,583.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,649.23 / $2,272.16 / $3,450.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,322.81 / $2,525.36 / $11,506.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,278.00 / $3,082.68 / $4,219.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,205.00 / $2,951.21 / $3,667.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,617.48 / $2,229.84 / $2,623.18
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
$1,322.81 / $2,531.98 / $3,673.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,705.70 / $3,183.20 / $3,310.50