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South Dakota rates for HCPCS 49402

Removal Peritoneal Foreign Body From Cavity

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$770.14 / $770.14 / $9,535.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$835.02 / $1,281.75 / $2,363.67
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.08 / $2,055.23 / $3,960.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,057.68 / $1,434.83 / $1,674.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00