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South Dakota rates for HCPCS 45800

Closure Rectovesical Fistula

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,144.29 / $1,144.29 / $1,144.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,034.66 / $1,097.71 / $1,949.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,989.20 / $2,736.20 / $3,420.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,239.07 / $1,889.77 / $3,221.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,337.60 / $2,340.62 / $9,181.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,826.71 / $2,824.09 / $3,969.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,733.00 / $2,796.19 / $3,413.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.52 / $2,078.86 / $2,485.39
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
$1,287.33 / $2,323.94 / $3,419.61
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,465.60 / $3,016.70 / $3,016.70