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South Dakota rates for HCPCS 61703

Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,242.79 / $1,242.79 / $1,242.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,063.92 / $1,242.79 / $3,993.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,829.57 / $2,863.97 / $3,579.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,521.41 / $2,000.00 / $3,483.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,398.31 / $2,447.05 / $9,687.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,808.89 / $3,203.96 / $4,221.39
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,058.00 / $2,900.31 / $3,696.65
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,687.50 / $2,341.69 / $2,704.04
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
$1,398.31 / $2,447.05 / $3,516.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,682.50 / $3,155.90 / $3,282.10