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South Dakota rates for HCPCS 49204

Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter

Insurance Carrier
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,298.89 / $2,458.00 / $3,185.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,872.92 / $2,533.96 / $2,613.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$571.12 / $571.12 / $571.12