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South Dakota rates for HCPCS 47715

Excision Choledochal Cyst

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,196.53 / $1,196.53 / $1,196.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.24 / $1,196.53 / $1,304.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,074.71 / $2,853.84 / $3,567.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,294.80 / $2,022.14 / $3,462.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,458.83 / $2,534.94 / $9,613.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,974.83 / $2,974.33 / $4,153.62
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,874.00 / $2,922.10 / $3,572.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,486.31 / $2,234.35 / $2,597.30
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
$1,394.22 / $2,308.86 / $3,591.56
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,576.60 / $3,152.60 / $3,152.60