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South Dakota rates for HCPCS 51820

Cystourethroplasty with unilateral or bilateral ureteroneocystostomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,025.58 / $1,025.58 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$923.90 / $1,025.58 / $3,113.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,367.52 / $2,425.34 / $3,031.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,321.18 / $1,733.23 / $3,152.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,365.89 / $2,276.48 / $10,018.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,775.73 / $2,678.74 / $3,305.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,869.00 / $2,367.52 / $2,869.16
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,386.63 / $1,845.75 / $2,104.37
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
$1,252.06 / $1,941.73 / $3,020.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,087.60 / $2,456.00 / $2,554.30