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South Dakota rates for HCPCS 35905

Excision Infected Graft Thorax

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,656.28 / $1,656.28 / $1,656.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,538.92 / $1,684.78 / $2,406.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,211.70 / $3,405.45 / $4,256.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,627.79 / $2,600.77 / $4,690.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,865.86 / $3,435.76 / $11,802.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,214.00 / $3,915.12 / $5,133.85
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,941.00 / $3,587.31 / $4,711.10
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,955.01 / $2,796.71 / $3,188.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,865.86 / $3,021.86 / $4,700.67
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,288.90 / $3,869.30 / $4,024.00