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South Dakota rates for HCPCS 51880

Closure of cystostomy (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$441.56 / $441.56 / $2,290.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$571.44 / $746.24 / $1,243.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.00 / $1,224.25 / $3,079.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.27 / $779.79 / $907.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00