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South Dakota rates for HCPCS 57400

Dilation of vagina under anesthesia (other than local)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.75 / $115.75 / $3,073.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.70 / $115.75 / $374.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.30 / $286.70 / $358.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.44 / $195.62 / $351.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.46 / $262.44 / $1,068.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.00 / $345.55 / $2,929.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.00 / $285.30 / $347.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.34 / $219.90 / $253.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.71 / $260.30 / $362.66
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.10 / $290.70 / $302.39