go back

South Dakota rates for HCPCS 35876

Thrmbc Artl/Ven Grf Xcp Hemo Grf/Fstl W/Revj Grf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$939.70 / $939.70 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,160.06 / $1,588.09 / $2,523.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,744.00 / $2,361.23 / $4,514.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.83 / $1,568.86 / $1,788.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$352.86 / $352.86 / $352.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00