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South Dakota rates for HCPCS 61650

Evasc Intracranial Prolng Admn Rx Agent Art 1st

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$517.95 / $517.95 / $517.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$582.65 / $756.09 / $1,381.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.67 / $1,362.58 / $1,762.41
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.28 / $968.37 / $1,139.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00