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South Dakota rates for HCPCS 35633

Bypass Graft W/Other Than Vein Ilio-Mesenteric

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,956.42 / $1,956.42 / $1,956.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,911.87 / $3,070.07 / $5,380.30
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,815.00 / $4,617.00 / $6,050.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.10 / $3,285.81 / $3,746.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00