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South Dakota rates for HCPCS 43847

Gastric Rstcv W/Byp W/Sm Int Rcnstj Limit Absrpj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,616.60 / $1,616.60 / $1,616.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,464.10 / $1,616.60 / $1,765.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,805.38 / $3,858.88 / $4,823.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,758.04 / $2,732.05 / $4,697.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,005.88 / $3,401.28 / $13,253.41
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,657.11 / $4,027.25 / $5,633.39
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,593.00 / $3,967.94 / $4,848.41
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.42 / $3,030.96 / $3,526.90
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
$1,870.70 / $3,321.30 / $4,855.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,498.80 / $4,280.89 / $4,280.89