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South Dakota rates for HCPCS 53400

Urethroplasty 1st Stg Fistula/Diverticulum/Strix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.70 / $758.70 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.83 / $1,282.20 / $2,139.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,375.00 / $2,093.08 / $4,555.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.30 / $1,333.30 / $1,559.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00