go back

South Dakota rates for HCPCS 51925

Closure of vesicouterine fistula; with hysterectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,027.44 / $1,027.44 / $1,027.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.64 / $1,027.44 / $2,879.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,327.67 / $2,380.15 / $2,975.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,310.80 / $1,736.37 / $2,905.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.51 / $2,051.71 / $7,980.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,587.86 / $2,648.62 / $3,353.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,651.00 / $2,351.52 / $2,904.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,282.52 / $1,833.27 / $2,090.13
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
$1,220.51 / $1,883.36 / $2,929.67
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,073.50 / $2,439.40 / $2,537.00