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South Dakota rates for HCPCS 58615

Occlusion Flp Tube Dev Vag/Suprapubic Appr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.93 / $230.93 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.96 / $230.93 / $679.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.04 / $564.85 / $706.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.39 / $390.27 / $640.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.41 / $484.02 / $2,806.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.00 / $659.37 / $2,929.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.77 / $554.58 / $685.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.56 / $419.02 / $492.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.41 / $484.02 / $692.02
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.40 / $565.20 / $587.79