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South Dakota rates for HCPCS 53520

Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$533.12 / $533.12 / $3,073.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.35 / $533.12 / $1,598.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,229.24 / $1,266.04 / $1,582.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.33 / $900.97 / $1,482.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.12 / $1,106.85 / $4,183.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$952.00 / $1,463.00 / $4,555.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$948.00 / $1,229.24 / $1,485.63
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.14 / $928.78 / $1,092.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$726.57 / $1,173.69 / $1,555.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,083.90 / $1,275.20 / $1,326.20