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South Dakota rates for HCPCS 64420

Injection Aa&/Strd Intercostal Nrv Single Lvl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.26 / $98.42 / $98.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.26 / $91.06 / $146.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.68 / $174.16 / $283.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.64 / $146.19 / $294.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.73 / $254.71 / $1,340.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.78 / $243.05 / $873.61
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.57 / $182.84 / $260.63
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.88 / $137.30 / $190.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,643.00 / $1,643.00 / $1,643.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.87 / $221.32 / $280.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.90 / $138.19 / $231.60