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South Dakota rates for HCPCS 58267

Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$964.59 / $964.59 / $964.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$897.90 / $964.59 / $1,328.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,340.59 / $2,358.34 / $2,947.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,284.00 / $1,630.16 / $2,779.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,227.97 / $2,063.73 / $7,932.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,601.71 / $2,633.13 / $3,325.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,691.00 / $2,340.59 / $2,884.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,287.59 / $1,768.48 / $2,080.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,345.27 / $2,558.28 / $2,940.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,027.50 / $2,385.30 / $2,480.69