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South Dakota rates for HCPCS 55815

Prostatectomy Perineal Rad W/Bi Pelvic Lymph Exc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,571.44 / $1,571.44 / $1,571.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,456.91 / $1,571.44 / $5,069.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,824.57 / $3,907.19 / $4,883.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,462.17 / $4,726.45
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,110.52 / $3,517.54 / $13,038.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,760.32 / $4,332.37 / $5,354.94
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,924.00 / $3,824.57 / $4,643.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,199.96 / $2,937.55 / $3,399.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,110.52 / $3,152.65 / $4,904.12
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,313.00 / $3,897.60 / $4,053.50