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South Dakota rates for HCPCS 52400

Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.48 / $450.48 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$581.04 / $761.31 / $1,279.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$951.00 / $1,245.80 / $3,079.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.10 / $796.03 / $925.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00