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South Dakota rates for HCPCS 50080

Perq Nl/Pl Lithotrp Simple Up To 2 Cm 1 Location

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.97 / $659.97 / $659.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$850.42 / $1,208.33 / $2,326.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,500.00 / $2,271.67 / $8,958.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.97 / $1,286.35 / $1,472.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00