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South Dakota rates for HCPCS 54692

Laparoscopy, surgical; orchiopexy for intra-abdominal testis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $4,365.16 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $794.33 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,737.80 / $2,187.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,174.90 / $5,370.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,348.96 / $5,623.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,659.59 / $1,778.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,584.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,288.25 / $1,479.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,479.11 / $2,089.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,698.24 / $1,737.80