go back

South Dakota rates for HCPCS 38115

Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,621.81 / $3,311.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $2,884.03 / $3,090.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,089.30 / $2,511.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26