go back

South Dakota rates for HCPCS 50930

Closure of ureterovisceral fistula (including visceral repair)

Facilitymedian $1,445 · 10th–90th $1,047–$4,3650%20%40%10th90th$1,445Professionalmedian $1,413 · 10th–90th $1,047–$2,9510%10%20%10th90th$1,413$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
$1,047.13 / $1,047.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,122.02 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,511.89 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,737.80 / $2,818.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,949.84 / $8,128.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,398.83 / $2,570.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,862.09 / $2,137.96
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
$1,096.48 / $2,187.76 / $3,090.30
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,511.89 / $2,570.40