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South Dakota rates for HCPCS 64865

Suture Facial Nerve Infratemporal W/Wo Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.49 / $1,071.49 / $1,071.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$901.93 / $1,071.49 / $2,553.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,869.12 / $2,433.13 / $3,041.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,374.06 / $1,803.86 / $2,934.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.30 / $2,313.15 / $8,063.68
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,704.56 / $2,676.02 / $9,202.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,704.56 / $2,309.86 / $2,914.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,339.90 / $1,844.05 / $2,102.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.30 / $1,942.31 / $3,021.37
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,085.69 / $2,551.90 / $2,551.90