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South Dakota rates for HCPCS 42955

Pharyngostomy Fstlj Pharynx Xtrnl Feeding

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.29 / $735.29 / $3,073.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.46 / $735.29 / $762.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,261.94 / $1,735.83 / $2,169.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$709.25 / $1,242.64 / $2,000.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$874.68 / $1,448.81 / $5,632.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,134.63 / $1,584.29 / $2,367.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$930.00 / $1,655.73 / $2,053.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$834.31 / $1,263.68 / $1,471.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.27 / $1,390.10 / $2,123.17
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,460.00 / $1,786.30 / $1,786.30