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South Dakota rates for HCPCS 35102

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 iliac vessels (common, hypogastric, external)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,857.17 / $1,857.17 / $1,857.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $3,138.62 / $5,047.74
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,372.00 / $4,196.54 / $5,733.51
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,357.39 / $3,123.54 / $3,561.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$701.48 / $701.48 / $701.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00