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South Dakota rates for HCPCS 64605

Dstrj Neurolytic Trigeminal Nrv 2/3 Div Branch

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.38 / $647.87 / $647.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.82 / $634.98 / $916.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$775.52 / $1,120.93 / $2,499.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.38 / $931.46 / $1,500.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.85 / $1,336.96 / $6,548.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.53 / $1,336.96 / $2,173.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$721.44 / $932.58 / $1,617.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622.96 / $893.92 / $1,734.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.34 / $1,363.13 / $1,817.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$834.30 / $1,020.80 / $2,105.90