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South Dakota rates for HCPCS 35005

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $977.24 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,096.48 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $2,630.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,659.59 / $2,511.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,698.24 / $8,317.64
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,187.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,698.24 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,949.84 / $2,630.27
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,290.87 / $2,398.83