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South Dakota rates for HCPCS 42600

Closure salivary fistula

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $537.03 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $512.86 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $1,047.13 / $1,621.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $645.65 / $1,258.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $831.76 / $4,073.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $891.25 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $724.44 / $1,047.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $707.95 / $1,047.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $660.69 / $1,174.90
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $851.14 / $1,288.25