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South Dakota rates for HCPCS 35092

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,553.75 / $2,553.75 / $2,553.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,509.50 / $4,315.84 / $6,970.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,721.00 / $6,045.91 / $7,962.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,266.87 / $4,313.93 / $4,918.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00