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South Dakota rates for HCPCS 58952

Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.44 / $1,481.44 / $1,481.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,982.52 / $2,503.63 / $4,277.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,461.59 / $4,055.96 / $5,093.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,042.21 / $2,737.38 / $3,209.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00