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South Dakota rates for HCPCS 58152

Tot Abd Hyst W/Wo Rmvl Tube Ovary W/Colpurethrxy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,111.54 / $1,111.54 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,035.53 / $1,111.54 / $3,513.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,706.68 / $2,720.62 / $3,400.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,480.81 / $1,878.50 / $3,299.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,458.14 / $2,430.23 / $9,166.95
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,901.94 / $3,043.09 / $3,840.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.00 / $2,706.68 / $3,331.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,531.31 / $2,070.73 / $2,405.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,458.14 / $2,216.59 / $3,448.03
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.60 / $2,758.40 / $2,868.70