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South Dakota rates for HCPCS 63064

Costovertebral Dcmprn Spinal Cord Thoracic 1 Seg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,634.89 / $1,634.89 / $1,634.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,195.77 / $2,786.72 / $4,566.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,581.55 / $3,879.75 / $5,508.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,205.38 / $3,016.46 / $3,476.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00