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South Dakota rates for HCPCS 64755

Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $870.96 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $891.25 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,041.74 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,479.11 / $2,398.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,412.54 / $9,772.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,041.74 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $1,905.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,548.82 / $1,819.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,584.89 / $2,454.71
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,089.30 / $2,187.76