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South Dakota rates for HCPCS 43107

Tot Esophagectomy W/O Thorcom W/Wo Pyloroplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,626.46 / $2,626.46 / $2,626.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,787.82 / $4,387.38 / $6,701.15
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,809.51 / $6,668.25 / $9,135.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,992.73 / $4,318.43 / $5,713.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00