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South Dakota rates for HCPCS 61705

Arysm Vasc Malfrmj/Crtd-Occlusion Crtd Art

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.48 / $2,344.48 / $2,344.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,004.98 / $2,344.48 / $7,656.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,371.84 / $5,378.91 / $6,723.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.14 / $3,962.19 / $6,675.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,898.95 / $5,026.80 / $18,351.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,741.58 / $6,069.49 / $8,056.94
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,008.00 / $5,506.14 / $7,042.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,182.98 / $4,497.13 / $5,135.09
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
$2,657.37 / $5,262.08 / $6,701.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,094.20 / $5,993.20 / $6,232.90