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South Dakota rates for HCPCS 43313

Esphgp Cgen Dfct Thrc Appr W/O Rpr Fstl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,587.06 / $2,587.06 / $2,587.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,346.04 / $2,587.06 / $2,650.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,500.60 / $6,190.73 / $7,738.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.32 / $4,372.13 / $7,104.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,213.41 / $5,283.84 / $20,891.91
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,192.39 / $6,247.89 / $9,005.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,203.00 / $6,105.39 / $7,288.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,250.50 / $4,366.59 / $5,655.85
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
$3,213.41 / $4,754.85 / $7,289.55
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,610.80 / $6,865.00 / $6,865.00