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South Dakota rates for HCPCS 54304

Penis Corrj Chordee/1st Stage Hypospadias Rpr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$673.35 / $673.35 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$625.08 / $673.35 / $2,157.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,636.09 / $1,678.96 / $2,098.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$893.86 / $1,137.96 / $2,081.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.41 / $1,489.02 / $5,588.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,329.00 / $1,959.35 / $3,079.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.20 / $1,636.09 / $1,981.64
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$937.16 / $1,248.58 / $1,454.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.41 / $1,489.02 / $2,089.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,417.20 / $1,667.30 / $1,734.00