go back

South Dakota rates for HCPCS 49600

Rpr Small Omphalocele W/Primary Closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$665.52 / $665.52 / $665.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.91 / $665.52 / $741.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,159.42 / $1,594.82 / $1,993.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$712.56 / $1,124.73 / $1,921.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$787.08 / $1,311.80 / $5,341.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,025.60 / $1,770.42 / $3,960.15
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.00 / $1,625.18 / $1,980.43
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$830.45 / $1,164.46 / $1,444.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$786.93 / $1,311.80 / $1,979.35
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,433.00 / $1,753.40 / $1,753.40