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South Dakota rates for HCPCS 64890

Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $3,090.30 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,071.52 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,454.71 / $3,090.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,778.28 / $2,884.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,819.70 / $7,943.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,454.71 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,398.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,778.28 / $2,137.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,905.46 / $3,019.95
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,454.71 / $2,570.40