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South Dakota rates for HCPCS 58200

Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,207.54 / $1,207.54 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,618.17 / $2,000.00 / $3,572.10
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,058.91 / $3,317.84 / $4,162.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.97 / $2,276.69 / $2,634.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00