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South Dakota rates for HCPCS 61586

Bicoronal Transzygmtc&/Lefort I W/O Bone Grft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,394.67 / $2,394.67 / $2,394.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,018.74 / $2,394.67 / $7,039.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,163.47 / $5,406.17 / $6,757.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,513.48 / $3,411.67 / $6,183.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,701.15 / $4,727.02 / $18,091.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,448.30 / $5,983.47 / $7,967.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,875.00 / $5,292.57 / $6,892.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,652.21 / $4,199.50 / $4,940.38
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
$3,727.46 / $6,268.33 / $6,549.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,901.00 / $5,765.90 / $5,996.60