go back

South Dakota rates for HCPCS 65103

Enucleation of eye; with implant, muscles not attached to implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $3,548.13 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,122.02 / $2,137.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,819.70 / $1,819.70
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,318.26 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28