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South Dakota rates for HCPCS 43886

Gastric restrictive procedure, open; revision of subcutaneous port component only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $2,290.87 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $380.19 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $851.14 / $1,047.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $512.86 / $1,000.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $549.54 / $2,691.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $891.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $602.56 / $724.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $588.84 / $977.24
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $891.25 / $891.25