go back

South Dakota rates for HCPCS 50725

Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,122.02 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,511.89 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,737.80 / $2,884.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,995.26 / $8,511.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,398.83 / $2,570.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $2,290.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,862.09 / $2,137.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,137.96 / $3,090.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,511.89 / $2,570.40