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South Dakota rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Facilitymedian $646 · 10th–90th $331–$3,5480%10%10th90th$646Professionalmedian $676 · 10th–90th $501–$8710%10%20%10th90th$676$500.0$1.0K$2.0K$5.0K$10.0K

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
$331.13 / $436.52 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $602.56 / $1,122.02
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $851.14 / $1,000.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $676.08 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $12,022.64