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South Dakota rates for HCPCS 39501

Repair Laceration Diaphragm Any Approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$787.75 / $787.75 / $787.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,076.16 / $1,320.87 / $2,219.78
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,268.72 / $2,047.05 / $2,645.67
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,057.72 / $1,427.29 / $1,657.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00