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South Dakota rates for HCPCS 61626

Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous, any method; non-central nervous system, head or neck (extracranial, brachiocephalic branch)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$828.31 / $828.31 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,012.17 / $1,399.84 / $2,309.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,324.29 / $2,152.21 / $2,734.34
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,088.22 / $1,488.99 / $1,755.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $6,571.00 / $6,571.00