go back

South Dakota rates for HCPCS 40700

Plstc Rpr Cl Lip/Nsl Dfrm Prim Prtl/Compl Uni

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$942.61 / $6,311.14 / $6,311.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$849.40 / $942.61 / $3,649.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,061.69 / $2,268.73 / $2,835.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,195.53 / $1,546.89 / $2,835.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$937.51 / $2,141.06 / $9,966.91
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,547.00 / $2,463.04 / $5,269.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,538.76 / $2,157.67 / $2,707.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,215.57 / $1,682.14 / $1,978.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.01 / $1,991.68 / $2,794.71
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,963.10 / $2,309.50 / $2,401.90