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South Dakota rates for HCPCS 54522

Orchiectomy Partial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.90 / $530.90 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.93 / $530.90 / $823.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,289.66 / $1,325.25 / $1,656.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$704.89 / $897.22 / $1,638.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$706.56 / $1,177.59 / $4,388.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,032.00 / $1,542.86 / $3,079.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,005.00 / $1,289.66 / $1,560.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.36 / $981.70 / $1,146.31
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
$706.56 / $1,171.72 / $1,644.16
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.09 / $1,314.30 / $1,366.90