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South Dakota rates for HCPCS 35876

Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $4,365.16 / $6,918.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,479.11 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $2,137.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,584.89 / $1,778.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$363.08 / $363.08 / $363.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $5,370.32