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South Dakota rates for HCPCS 63290

Lam Bx/Exc Ispi Neo Xdrl-Idrl Les Any Lvl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,513.67 / $2,513.67 / $2,513.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,150.12 / $2,513.67 / $6,669.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,431.29 / $5,768.46 / $7,210.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,088.65 / $4,248.12 / $7,161.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,578.39 / $5,427.09 / $19,678.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,003.34 / $5,971.86 / $8,633.62
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,003.34 / $5,820.91 / $7,483.31
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,440.60 / $4,823.78 / $5,505.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $6,571.00 / $6,571.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,578.39 / $4,781.01 / $7,188.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,461.30 / $6,682.10 / $6,682.10