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South Dakota rates for HCPCS 61613

Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,998.17 / $2,998.17 / $2,998.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,549.03 / $2,998.17 / $9,605.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,820.15 / $6,889.23 / $8,526.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,295.21 / $4,307.85 / $8,417.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,634.63 / $6,360.61 / $23,209.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,680.70 / $7,676.26 / $10,239.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,631.00 / $7,094.12 / $8,910.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,078.29 / $5,651.87 / $6,443.77
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
$3,634.63 / $6,360.61 / $8,556.62
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,392.50 / $7,520.60 / $7,821.40