go back

South Dakota rates for HCPCS 52250

Cystourethroscopy Insj Radioact Sbst W/Wobx/Fulg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.54 / $223.54 / $223.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.21 / $223.54 / $690.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.46 / $528.23 / $660.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.73 / $377.78 / $644.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.42 / $475.70 / $1,761.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.00 / $621.10 / $3,079.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.00 / $517.46 / $628.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.27 / $400.34 / $459.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.42 / $492.83 / $664.05
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.30 / $536.79 / $558.29