go back

South Dakota rates for HCPCS 41805

Removal of embedded foreign body from dentoalveolar structures; soft tissues

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $309.03 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $269.15 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $575.44 / $912.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $288.40 / $660.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $478.63 / $2,290.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $478.63 / $758.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $524.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $380.19 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $354.81 / $660.69
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $457.09 / $707.95