go back

South Dakota rates for HCPCS 57292

Construction Artificial Vagina W/Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$748.22 / $748.22 / $748.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.55 / $748.22 / $2,278.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,812.94 / $1,829.33 / $2,286.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$996.07 / $1,264.49 / $2,150.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.87 / $1,597.70 / $7,983.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,245.16 / $2,040.33 / $2,575.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,334.00 / $1,812.94 / $2,235.04
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$999.43 / $1,369.80 / $1,611.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.87 / $1,464.21 / $2,277.66
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,570.40 / $1,847.60 / $1,921.50