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South Dakota rates for HCPCS 64644

Chemodenervation 1 Extremity 5 Or More Muscles

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.42 / $173.24 / $173.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.48 / $148.75 / $397.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.10 / $316.51 / $503.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.22 / $250.24 / $405.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.33 / $377.30 / $1,307.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.77 / $280.45 / $427.97
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.55 / $313.27 / $427.97
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.51 / $248.70 / $347.39
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
$174.33 / $332.81 / $470.51
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.60 / $274.80 / $421.70