go back

South Dakota rates for HCPCS 61640

Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $436.52 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $446.68 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,288.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $741.31 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $831.76 / $5,754.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,122.02
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $851.14 / $1,047.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $933.25 / $1,288.25
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,047.13 / $1,096.48