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South Dakota rates for HCPCS 50976

Ureteral Endosc Via Ureterot W/Dest&/Inc W/Wo Bx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.50 / $433.50 / $2,290.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.60 / $433.50 / $1,343.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,005.10 / $1,022.96 / $1,278.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$558.55 / $732.62 / $1,254.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.03 / $926.72 / $3,428.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$819.00 / $1,210.79 / $4,555.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.00 / $1,005.10 / $1,219.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.27 / $778.63 / $893.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.03 / $914.08 / $1,293.74
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$886.30 / $1,042.70 / $1,084.40