go back

South Dakota rates for HCPCS 42507

Parotid Duct Diversion Bilateral Wilke Px

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$475.91 / $475.91 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.95 / $475.91 / $498.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.71 / $1,128.92 / $1,411.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.54 / $845.34 / $1,415.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.32 / $952.08 / $4,794.81
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$768.74 / $1,227.48 / $6,855.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$768.74 / $1,085.86 / $1,340.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.70 / $846.56 / $965.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.32 / $1,000.54 / $1,386.70
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$957.50 / $1,171.50 / $1,171.50