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South Dakota rates for HCPCS 64633

Dstr Nrolytc Agnt Parverteb Fct Sngl Crvcl/Thora

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$187.78 / $447.61 / $3,429.41
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,459.78 / $2,459.78 / $2,459.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.78 / $425.72 / $992.70
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$276.74 / $281.82 / $407.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$403.92 / $731.22 / $1,257.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.25 / $586.29 / $1,027.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.72 / $961.99 / $3,260.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.82 / $938.14 / $2,173.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.28 / $637.37 / $1,104.91
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.29 / $598.54 / $833.85
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
$443.86 / $760.45 / $1,182.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.30 / $453.10 / $1,012.10