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South Dakota rates for HCPCS 52353

Cysto W/Ureteroscopy W/Lithotripsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$365.04 / $6,406.52 / $13,770.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.03 / $693.31 / $2,004.81
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$743.00 / $1,017.83 / $4,555.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.42 / $655.04 / $750.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00