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South Dakota rates for HCPCS 64893

Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $3,090.30 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,122.02 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,570.40 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $1,819.70 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,905.46 / $8,128.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,511.89 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,511.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,862.09 / $2,187.76
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
$1,230.27 / $1,995.26 / $3,162.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,570.40 / $2,691.53