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South Dakota rates for HCPCS 64555

Prq Impltj Neurostimulator Eltrd Peripheral Nrv

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.63 / $2,242.11 / $2,242.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.71 / $510.43 / $3,070.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.77 / $2,113.94 / $6,076.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$276.69 / $536.79 / $3,538.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.71 / $2,665.25 / $15,677.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$626.04 / $3,538.63 / $13,755.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.91 / $791.70 / $4,466.29
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.72 / $634.61 / $3,975.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.69 / $2,621.69 / $5,330.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$629.60 / $770.30 / $4,825.80