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South Dakota rates for HCPCS 64901

Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure)

Facilitymedian $955 · 10th–90th $562–$4,3650%20%10th90th$955Professionalmedian $724 · 10th–90th $562–$1,4450%20%10th90th$724$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $3,090.30 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $588.84 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,318.26 / $1,621.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $933.25 / $1,445.44
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $1,047.13 / $4,265.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,348.96 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,230.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $977.24 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $1,000.00 / $1,548.82
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,380.38 / $1,380.38