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South Dakota rates for HCPCS 52330

Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $645.65 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $524.81 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $1,202.26 / $1,698.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $758.58 / $2,691.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $1,047.13 / $9,120.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $616.60 / $1,230.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $1,000.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $831.76 / $1,122.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $707.95 / $1,380.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $616.60 / $1,348.96