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South Dakota rates for HCPCS 62264

Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day

Facilitymedian $447 · 10th–90th $240–$2,2910%10%10th90th$447Professionalmedian $457 · 10th–90th $240–$1,0230%10%20%10th90th$457$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $446.68 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $446.68 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $912.01 / $1,288.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $616.60 / $1,023.29
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $891.25 / $3,548.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $562.34 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $537.03 / $933.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $602.56 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $537.03 / $1,174.90
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $575.44 / $1,023.29