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South Dakota rates for HCPCS 43425

Closure of esophagostomy or fistula; transthoracic or transabdominal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,272.89 / $1,272.89 / $1,272.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,154.54 / $1,272.89 / $1,400.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,206.69 / $3,035.37 / $3,794.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,413.48 / $2,151.17 / $3,797.29
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,666.04 / $2,785.48 / $10,307.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,177.05 / $3,218.50 / $4,432.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,175.00 / $3,125.88 / $3,822.75
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,681.35 / $2,436.98 / $2,778.44
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
$1,666.04 / $2,785.48 / $3,853.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,756.30 / $3,372.40 / $3,372.40