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South Dakota rates for HCPCS 49452

Replacement Gastro-Jejunostomy Tube Percutaneous

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.59 / $1,331.24 / $1,572.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.59 / $2,022.97 / $3,474.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.31 / $431.80 / $2,174.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.06 / $668.20 / $2,217.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,042.90 / $1,820.90 / $5,607.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.34 / $1,213.17 / $2,165.92
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.13 / $1,605.51 / $2,111.35
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.96 / $1,088.08 / $1,485.31
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
$1,042.90 / $1,606.21 / $2,498.55
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.70 / $314.10 / $1,732.20