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South Dakota rates for HCPCS 52007

Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $457.09 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $562.34 / $1,202.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $389.05 / $1,047.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $630.96 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53