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South Dakota rates for HCPCS 52354

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $3,715.35 / $7,762.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $588.84 / $1,122.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $891.25 / $977.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $707.95 / $794.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53