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South Dakota rates for HCPCS 54164

Frenulotomy Penis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.43 / $177.43 / $3,073.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.00 / $299.86 / $539.97
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$322.00 / $504.42 / $1,759.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.18 / $326.08 / $383.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00