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South Dakota rates for HCPCS 33965

Ecmo/Ecls Rmvl Of Perph Cannula Perq Birth-5 Yrs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.37 / $184.37 / $184.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.06 / $191.58 / $267.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.10 / $378.64 / $473.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.92 / $287.39 / $519.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.34 / $368.90 / $1,295.83
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$376.58 / $429.96 / $564.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.37 / $414.52 / $535.66
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.67 / $306.39 / $349.33
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
$221.34 / $368.90 / $491.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.30 / $423.90 / $440.90