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South Dakota rates for HCPCS 54115

Removal foreign body from deep penile tissue (eg, plastic implant)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$387.65 / $418.16 / $418.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.03 / $389.15 / $1,219.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.76 / $1,048.67 / $1,310.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516.27 / $657.66 / $1,196.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.41 / $1,216.80 / $3,962.57
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$772.00 / $1,140.71 / $2,103.33
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$771.00 / $993.73 / $1,219.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.51 / $749.04 / $898.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $817.25 / $1,271.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$815.80 / $998.20 / $1,071.40