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South Dakota rates for HCPCS 50688

Chng Urtrost Tube/Xtrnlly Accessible Stent Ileal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.39 / $74.39 / $9,315.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.80 / $74.39 / $225.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.02 / $178.41 / $223.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.27 / $125.72 / $213.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.76 / $159.60 / $655.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.00 / $200.14 / $1,759.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.22 / $171.02 / $204.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.31 / $133.34 / $152.02
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
$95.76 / $159.60 / $219.32
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.80 / $177.40 / $184.50