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South Dakota rates for HCPCS 49611

Repair of omphalocele (Gross type operation); second stage

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.94 / $555.94 / $555.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.02 / $555.94 / $597.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$969.68 / $1,333.82 / $1,667.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$611.48 / $939.54 / $1,556.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.15 / $1,106.92 / $4,535.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.02 / $1,364.41 / $1,911.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$936.00 / $1,238.89 / $1,649.29
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$667.61 / $951.44 / $1,204.53
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
$664.15 / $1,106.92 / $1,645.64
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,194.90 / $1,462.00 / $1,462.00