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South Dakota rates for HCPCS 50722

Ureterolysis for ovarian vein syndrome

Facilitymedian $1,318 · 10th–90th $955–$4,3650%20%10th90th$1,318Professionalmedian $1,318 · 10th–90th $955–$2,6920%20%10th90th$1,318$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,047.13 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,290.87 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,621.81 / $2,691.53
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,819.70 / $7,585.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,238.72 / $2,344.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,737.80 / $1,995.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,041.74 / $2,818.38
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,290.87 / $2,398.83