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South Dakota rates for HCPCS 58290

Vaginal hysterectomy, for uterus greater than 250 g;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $4,365.16 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,047.13 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,570.40 / $3,235.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,698.24 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $2,041.74 / $8,511.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,511.89 / $2,630.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,398.83 / $2,398.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,905.46 / $2,238.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,137.96 / $3,162.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,570.40 / $2,691.53