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South Dakota rates for HCPCS 46753

Graft Thiersch Rct Incontinence &/Prolapse

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$567.77 / $567.77 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.55 / $567.77 / $607.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.20 / $1,363.43 / $1,704.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$608.40 / $909.21 / $1,632.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$634.67 / $1,141.66 / $4,513.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$886.20 / $1,495.65 / $3,285.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$807.00 / $1,373.78 / $1,674.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$658.07 / $966.03 / $1,221.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.91 / $1,136.46 / $1,674.26
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,211.59 / $1,482.50 / $1,482.50