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South Dakota rates for HCPCS 49040

Drainage Subdiaphragmatic/Subphren Abscess Open

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.87 / $907.87 / $907.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$979.58 / $1,496.92 / $2,611.26
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,493.06 / $2,244.67 / $3,132.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.70 / $1,679.10 / $1,964.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00