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South Dakota rates for HCPCS 50972

Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $2,290.87 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $363.08 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $812.83 / $1,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $524.81 / $954.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $645.65 / $2,630.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $776.25 / $851.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $602.56 / $691.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $676.08 / $1,000.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $794.33 / $831.76