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South Dakota rates for HCPCS 52356

Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$386.80 / $6,300.00 / $11,025.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.44 / $933.61 / $6,243.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$896.65 / $913.11 / $1,141.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$498.43 / $653.69 / $4,288.79
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,031.74 / $5,031.74 / $5,031.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.72 / $825.98 / $3,057.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$817.96 / $1,062.11 / $4,555.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.47 / $977.48 / $1,088.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.12 / $694.50 / $796.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.59 / $741.29 / $1,153.11
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.60 / $930.20 / $967.40