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South Dakota rates for HCPCS 35122

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,089.30 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $4,897.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $2,951.21 / $4,786.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $3,162.28 / $13,182.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,168.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $3,235.94 / $3,715.35
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
$2,290.87 / $3,715.35 / $5,011.87
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $4,365.16 / $4,570.88