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South Dakota rates for HCPCS 35091

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, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,757.76 / $1,757.76 / $1,757.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,970.61 / $4,788.85
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,396.00 / $4,143.67 / $5,465.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,241.06 / $2,960.13 / $3,374.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$666.86 / $666.86 / $666.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00