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South Dakota rates for HCPCS 64640

Dstrj Neurolytic Agent Other Peripheral Nerve

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.27 / $251.24 / $1,135.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.27 / $207.71 / $372.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.27 / $420.84 / $723.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.88 / $312.22 / $428.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.88 / $350.46 / $1,848.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.94 / $312.22 / $576.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.38 / $279.87 / $484.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.61 / $234.18 / $481.94
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
$198.66 / $350.46 / $700.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.30 / $284.20 / $585.00