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South Dakota rates for HCPCS 55873

Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $4,365.16 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $3,019.95 / $7,079.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,187.76 / $16,595.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $2,089.30 / $15,848.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $11,748.98 / $41,686.94
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,778.28 / $14,125.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $12,589.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $7,943.28 / $11,748.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $2,137.96 / $16,982.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,778.28 / $12,589.25