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South Dakota rates for HCPCS 57305

Clsr Rectovaginal Fistula Abdominal Approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$886.08 / $886.08 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,120.85 / $1,497.48 / $2,446.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,402.48 / $2,393.42 / $3,077.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,156.76 / $1,610.66 / $1,894.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00