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South Dakota rates for HCPCS 50840

Replacement of all or part of ureter by intestine segment, including intestine anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,148.15 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,258.93 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $2,818.38 / $3,548.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,949.84 / $3,162.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $2,187.76 / $9,772.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,691.53 / $2,884.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,089.30 / $2,398.83
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
$1,348.96 / $2,344.23 / $3,388.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,754.23 / $2,884.03