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South Dakota rates for HCPCS 58275

Vaginal hysterectomy, with total or partial vaginectomy;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$893.05 / $893.05 / $893.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.98 / $1,509.25 / $2,598.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,498.95 / $2,443.34 / $3,072.20
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,204.79 / $1,642.00 / $1,931.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00