go back

South Dakota rates for HCPCS 50957

Ureteral Endoscopy W/Dest&/Inc W/Wo Biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$330.22 / $412.26 / $412.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$297.29 / $371.29 / $1,021.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$764.19 / $973.88 / $1,227.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.12 / $676.86 / $1,102.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.76 / $1,151.03 / $5,828.17
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$774.00 / $1,066.73 / $4,412.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$764.19 / $919.09 / $1,135.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.61 / $679.25 / $842.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.76 / $858.82 / $1,202.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.80 / $824.50 / $1,023.10