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South Dakota rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Facilitymedian $229 · 10th–90th $129–$3,0900%10%10th90th$229Professionalmedian $214 · 10th–90th $132–$4170%10%10th90th$214$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $213.80 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $398.11 / $645.65
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $263.03 / $562.34
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $371.54 / $1,621.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $338.84 / $489.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $446.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $269.15 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $281.84 / $478.63
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $323.59 / $512.86