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South Dakota rates for HCPCS 51565

Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,318.26 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $2,951.21 / $3,630.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $1,995.26 / $3,388.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $2,344.23 / $15,135.61
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $2,818.38 / $3,019.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,187.76 / $2,511.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,454.71 / $3,630.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,884.03 / $3,019.95