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South Dakota rates for HCPCS 41822

Exc Fibrous Tuberosities Dentoalveolar Struxs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.45 / $347.20 / $347.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.07 / $308.35 / $348.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.44 / $578.48 / $1,027.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.85 / $436.43 / $819.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.19 / $659.65 / $2,621.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.18 / $596.99 / $868.06
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.28 / $541.65 / $793.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.16 / $440.20 / $678.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.31 / $624.16 / $970.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.20 / $486.00 / $838.60