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South Dakota rates for HCPCS 42665

Ligation salivary duct, intraoral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $371.54 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $331.13 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $645.65 / $1,122.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $354.81 / $812.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $562.34 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $537.03 / $933.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $436.52 / $660.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $457.09 / $724.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $416.87 / $794.33
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $524.81 / $870.96