go back

South Dakota rates for HCPCS 43762

Perq Replacement Gtube Not Req Revj Gstrst Trc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.31 / $204.12 / $226.24
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$16.66 / $16.66 / $113.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.56 / $197.71 / $371.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.92 / $333.41 / $643.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.36 / $197.71 / $488.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.40 / $448.14 / $1,659.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.08 / $307.14 / $599.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.52 / $410.60 / $599.07
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.02 / $232.13 / $425.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.21 / $448.14 / $644.11
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.90 / $87.90 / $515.90