go back

South Dakota rates for HCPCS 42260

Repair Nasolabial Fistula

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$635.17 / $830.12 / $830.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.76 / $743.70 / $833.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,103.91 / $1,717.86 / $2,453.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$743.70 / $1,240.64 / $2,247.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$993.11 / $1,755.29 / $6,428.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,394.00 / $1,994.91 / $5,269.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,276.00 / $1,659.50 / $2,231.48
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.71 / $1,313.21 / $1,645.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$970.00 / $1,812.61 / $2,316.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,302.80 / $1,594.00 / $2,031.30