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South Dakota rates for HCPCS 43641

Vgtmy W/Pyloroplasty W/Wo Gastrost Parietal Cell

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,080.91 / $1,080.91 / $1,080.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$979.67 / $1,080.91 / $1,177.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,879.88 / $2,585.83 / $3,232.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.79 / $1,826.74 / $3,130.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,321.48 / $2,290.28 / $8,760.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,786.24 / $2,683.58 / $3,756.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,700.00 / $2,651.36 / $3,235.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,421.42 / $2,019.68 / $2,356.66
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
$1,259.65 / $2,206.38 / $3,240.08
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,337.90 / $2,860.50 / $2,860.50