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South Dakota rates for HCPCS 50387

Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.77 / $570.04 / $570.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.27 / $694.55 / $1,388.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.75 / $1,174.61 / $1,781.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.18 / $759.14 / $1,018.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00