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South Dakota rates for HCPCS 43497

Transoral Lower Esophageal Myotomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$734.86 / $734.86 / $3,073.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$761.06 / $1,117.31 / $2,234.89
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,448.80 / $1,933.23 / $2,440.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$971.75 / $1,337.36 / $1,524.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00