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South Dakota rates for HCPCS 61558

Xtn Craniect Multiple Suture Craniosynostosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,712.61 / $1,712.61 / $1,712.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,465.52 / $1,712.61 / $5,522.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,862.86 / $3,939.91 / $4,924.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,476.73 / $4,304.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,097.83 / $3,621.38 / $15,979.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,702.42 / $4,420.84 / $5,837.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,609.00 / $3,862.86 / $5,111.41
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,382.86 / $3,171.82 / $3,731.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,097.83 / $3,479.69 / $4,856.39
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,701.60 / $4,354.80 / $4,529.00