go back

South Dakota rates for HCPCS 61623

Evasc Temp Balloon Artl Occlusion Head/Neck

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$522.51 / $522.51 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$571.76 / $883.04 / $1,473.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$845.32 / $1,353.65 / $1,767.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.46 / $953.85 / $1,119.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $6,571.00 / $6,571.00