go back

South Dakota rates for HCPCS 58263

Vag Hyst 250 Gm/< W/Rmvl Tube Ovary W/Rpr Ntrcl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$896.02 / $896.02 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,194.38 / $1,514.27 / $2,607.94
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,507.86 / $2,450.19 / $3,085.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,209.73 / $1,646.95 / $1,937.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00