go back

South Dakota rates for HCPCS 58760

Fimbrioplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $4,365.16 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $758.58 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,862.09 / $2,344.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,258.93 / $2,137.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,445.44 / $7,079.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,778.28 / $1,862.09
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,348.96 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,513.56 / $2,187.76
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,819.70 / $1,905.46