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South Dakota rates for HCPCS 63704

Repair of myelomeningocele; less than 5 cm diameter

Facilitymedian $2,344 · 10th–90th $1,549–$4,3650%20%10th90th$2,344Professionalmedian $2,089 · 10th–90th $1,549–$4,0740%10%10th90th$2,089$2.0K$5.0K$10.0K

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
$1,548.82 / $1,548.82 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,659.59 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,630.78 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,454.71 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,754.23 / $12,022.64
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,548.13 / $3,548.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,235.94
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,570.40 / $3,311.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,754.23 / $4,168.69
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,073.80 / $4,073.80