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South Dakota rates for HCPCS 61790

Create Lesion Strtctc Prq Neurolytic Gasserian

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$817.33 / $817.33 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$992.97 / $1,293.08 / $2,247.63
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,387.40 / $1,982.52 / $2,749.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,114.26 / $1,506.78 / $1,762.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00