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South Dakota rates for HCPCS 42500

Plstc Rpr Salivary Dux Sialodochoplasty Prim

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.82 / $439.33 / $439.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$391.74 / $662.04 / $1,129.02
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$685.00 / $1,069.96 / $5,269.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.54 / $679.89 / $862.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00