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South Dakota rates for HCPCS 43633

Gstrct Prtl Dstl W/Roux-En-Y Rcnstj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,714.53 / $1,714.53 / $1,714.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,826.52 / $2,627.78 / $5,010.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,863.04 / $4,305.60 / $5,967.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,140.33 / $3,226.49 / $3,746.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$718.21 / $718.21 / $718.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00