go back

South Dakota rates for HCPCS 57220

Plastic Urethral Sphincter Vaginal Approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.73 / $318.73 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.24 / $538.65 / $836.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$539.00 / $866.97 / $4,114.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.48 / $546.58 / $677.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00