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South Dakota rates for HCPCS 43460

Esopg/Gstr Tamponade W/Balo Sengstaken Type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.28 / $196.28 / $196.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.40 / $196.28 / $213.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.97 / $469.02 / $586.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.53 / $354.80 / $598.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.82 / $409.28 / $1,798.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$334.68 / $500.82 / $646.55
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.00 / $458.51 / $559.66
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.54 / $357.46 / $407.55
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
$235.42 / $416.76 / $593.26
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.30 / $494.70 / $494.70