go back

South Dakota rates for HCPCS 40720

Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $4,365.16 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,047.13 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,344.23 / $2,951.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,584.89 / $2,884.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,949.84 / $7,585.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,344.23 / $2,344.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,137.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,737.80 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,819.70 / $2,754.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $2,454.71