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South Dakota rates for HCPCS 55120

Removal Foreign Body Scrotum

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.54 / $323.54 / $3,073.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.35 / $323.54 / $1,016.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$786.02 / $812.60 / $1,015.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$353.19 / $546.78 / $991.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.22 / $715.36 / $2,669.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $928.95 / $1,759.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.00 / $786.02 / $945.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.79 / $594.71 / $698.65
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
$429.22 / $635.69 / $988.85
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.90 / $801.00 / $833.10