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South Dakota rates for HCPCS 42820

Tonsillectomy & Adenoidectomy < Age 12

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,475.00 / $5,051.34 / $6,613.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.33 / $424.22 / $4,080.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.84 / $666.91 / $833.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$289.69 / $523.28 / $832.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.68 / $551.49 / $2,630.26
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.18 / $726.57 / $6,855.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.00 / $647.01 / $768.65
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.40 / $487.37 / $575.09
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
$342.68 / $513.17 / $798.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$570.50 / $698.00 / $698.00