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South Dakota rates for HCPCS 58263

Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $4,365.16 / $4,897.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,513.56 / $2,630.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,187.76 / $2,290.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,659.59 / $1,949.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28