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South Dakota rates for HCPCS 58140

Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $4,365.16 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $977.24 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,089.30 / $2,630.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,348.96 / $2,398.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,659.59 / $6,760.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $1,995.26 / $2,089.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $1,905.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,548.82 / $1,778.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,698.24 / $2,511.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,041.74 / $2,137.96