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South Dakota rates for HCPCS 64905

Nerve Pedicle Transfer First Stage

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$971.55 / $971.55 / $3,073.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,176.51 / $1,638.02 / $2,696.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,564.40 / $2,441.91 / $7,260.61
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,251.96 / $1,708.44 / $1,947.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$379.24 / $379.24 / $379.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $12,808.14