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South Dakota rates for HCPCS 53415

Urtp Transpubic/Prnl 1 Stg Rcnstj/Rpr Urt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,065.36 / $1,065.36 / $1,065.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,372.47 / $1,800.48 / $3,025.50
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,759.29 / $2,786.00 / $3,442.38
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,414.18 / $1,882.17 / $2,185.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00