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South Dakota rates for HCPCS 54900

Epididymovasostomy Anast Epididymis Uni

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$721.11 / $721.11 / $721.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.26 / $721.11 / $2,300.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,753.27 / $1,798.94 / $2,248.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.04 / $1,218.68 / $2,228.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.06 / $1,651.76 / $5,965.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,312.00 / $1,877.51 / $2,443.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,331.00 / $1,753.27 / $2,122.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.04 / $1,346.64 / $1,558.38
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
$991.06 / $1,435.63 / $2,233.19
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,518.70 / $1,786.80 / $1,858.20