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South Dakota rates for HCPCS 34709

Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.95 / $317.95 / $2,290.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.39 / $497.35 / $806.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$577.03 / $749.11 / $983.41
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.66 / $533.36 / $608.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$120.71 / $120.71 / $120.71
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$120.71 / $120.71 / $120.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00