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South Dakota rates for HCPCS 64620

Destruction by neurolytic agent, intercostal nerve

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $208.93 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $208.93 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $489.78 / $616.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $331.13 / $524.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $407.38 / $1,584.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $407.38 / $478.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $389.05 / $457.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $346.74 / $407.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $338.84 / $562.34
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $426.58 / $501.19