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South Dakota rates for HCPCS 61702

Simple Intracranial Arysm Vertebrobasilar Crcj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,598.93 / $3,598.93 / $3,598.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,077.66 / $3,598.93 / $11,756.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,246.49 / $8,330.03 / $10,309.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,051.33 / $5,695.22 / $10,331.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,460.28 / $7,805.49 / $28,223.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,764.79 / $9,334.75 / $12,414.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,458.00 / $8,628.56 / $10,853.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,941.79 / $6,933.63 / $7,905.12
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
$5,266.85 / $9,915.12 / $10,359.08
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,842.20 / $9,226.10 / $9,595.10