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South Dakota rates for HCPCS 50980

Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.77 / $331.77 / $2,290.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.60 / $331.77 / $1,027.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.09 / $782.22 / $977.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.00 / $560.69 / $960.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.48 / $707.46 / $2,618.64
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$628.00 / $924.47 / $4,555.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.00 / $767.09 / $933.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.87 / $596.45 / $681.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $10,167.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.51 / $636.01 / $989.35
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.40 / $795.80 / $827.60