go back

South Dakota rates for HCPCS 58760

Fimbrioplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.79 / $741.79 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$690.21 / $741.79 / $2,256.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,796.94 / $1,812.97 / $2,266.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$987.00 / $1,253.63 / $2,131.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$945.30 / $1,585.02 / $7,017.19
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,231.93 / $2,022.27 / $2,553.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,327.00 / $1,796.94 / $2,215.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$987.52 / $1,357.70 / $1,597.20
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
$945.30 / $1,575.50 / $2,259.10
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,556.60 / $1,831.30 / $1,904.50