go back

South Dakota rates for HCPCS 49203

Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less

Insurance Carrier
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,797.24 / $1,929.00 / $2,494.07
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,367.93 / $1,679.23 / $2,044.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$446.55 / $446.55 / $446.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$446.55 / $446.55 / $446.55