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South Dakota rates for HCPCS 49013

Preperitoneal Pel Pack F/Hemrrg Assoc Pel Trma

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.92 / $399.92 / $399.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$449.07 / $612.39 / $1,244.25
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$742.35 / $1,078.55 / $1,415.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$617.27 / $772.80 / $881.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00