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South Dakota rates for HCPCS 51580

Cystectomy W/Ureterosigmoidostomy W/Nodes

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,781.22 / $1,781.22 / $1,781.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,604.30 / $1,781.22 / $5,451.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,116.42 / $4,205.58 / $5,256.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,813.77 / $5,081.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,279.67 / $3,799.46 / $24,470.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,979.78 / $4,663.75 / $5,764.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,030.00 / $4,116.42 / $4,994.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,368.63 / $3,158.61 / $3,658.87
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
$2,279.67 / $3,714.72 / $5,275.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,629.70 / $4,270.30 / $4,441.10