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South Dakota rates for HCPCS 55873

Cryosurgical Ablation Prostate W/Us & Monitori

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.51 / $4,338.00 / $5,568.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.17 / $4,955.21 / $5,568.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,717.92 / $9,377.87 / $16,124.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,005.20 / $2,106.54 / $15,996.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,596.34 / $16,881.93 / $41,874.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,893.01 / $11,332.99 / $16,679.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,674.65 / $7,161.49 / $15,996.34
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,261.42 / $7,862.94 / $11,631.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $6,571.00 / $6,571.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,879.98 / $11,338.61 / $17,637.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,450.70 / $1,774.90 / $12,575.60