go back

South Dakota rates for HCPCS 42120

Resection of palate or extensive resection of lesion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$965.10 / $965.10 / $965.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$859.36 / $1,452.32 / $2,714.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,554.00 / $2,463.80 / $6,855.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,102.69 / $1,676.20 / $1,950.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00