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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
$208.32 / $372.11 / $372.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.98 / $330.00 / $372.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.03 / $631.07 / $1,083.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.15 / $471.90 / $818.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.14 / $666.54 / $2,803.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.88 / $744.90 / $2,389.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$412.27 / $586.08 / $856.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $464.08 / $723.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.93 / $666.54 / $969.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.40 / $522.90 / $879.40