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South Dakota rates for HCPCS 64643

Chemodenervation 1 Extremity Ea Addl 1-4 Muscle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.17 / $89.88 / $89.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.40 / $84.79 / $214.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.35 / $188.93 / $261.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.03 / $132.69 / $240.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.65 / $208.41 / $687.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.77 / $186.70 / $245.94
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.22 / $187.35 / $245.94
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.87 / $135.44 / $181.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.65 / $184.64 / $253.74
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.50 / $163.30 / $220.60