go back

South Dakota rates for HCPCS 35304

Teaec W/Graft Tibioperoneal Trunk Artery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,260.33 / $1,260.33 / $1,260.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.58 / $1,982.44 / $3,430.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,284.00 / $2,854.01 / $3,897.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,601.00 / $2,119.23 / $2,416.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00