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South Dakota rates for HCPCS 52353

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $6,456.54 / $9,772.37
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $691.83 / $4,466.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $851.14 / $912.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $660.69 / $758.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84