go back

South Dakota rates for HCPCS 49428

Ligation Peritoneal-Venous Shunt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.62 / $388.62 / $388.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.02 / $388.62 / $422.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.28 / $930.25 / $1,162.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.57 / $656.77 / $1,335.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.78 / $839.92 / $3,122.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$670.23 / $965.29 / $1,342.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.00 / $949.77 / $1,158.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$473.39 / $740.46 / $896.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.78 / $864.04 / $1,163.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$837.50 / $1,024.70 / $1,024.70