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South Dakota rates for HCPCS 35631

Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,829.64 / $1,829.64 / $1,829.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,878.54 / $4,950.22
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,441.00 / $4,321.50 / $5,642.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,323.21 / $3,069.63 / $3,499.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00