go back

South Dakota rates for HCPCS 51040

Cystostomy Cystotomy W/Drainage

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.95 / $279.95 / $279.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.43 / $473.12 / $766.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$498.00 / $762.01 / $1,759.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.55 / $487.21 / $573.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$107.58 / $107.58 / $107.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00