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South Dakota rates for HCPCS 50830

Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,819.70 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $4,073.80 / $5,128.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $2,454.71 / $4,677.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $3,235.94 / $13,182.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $3,890.45 / $4,265.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,019.95 / $3,467.37
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
$1,995.26 / $3,388.44 / $5,011.87
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,467.37 / $4,073.80 / $4,265.80