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South Dakota rates for HCPCS 65125

Modificaj Oc Implt W/Plmt/Rplcmt Pegs Spx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$314.35 / $497.83 / $497.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.70 / $403.11 / $794.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.21 / $853.11 / $1,312.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.12 / $510.61 / $1,104.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.56 / $858.38 / $2,197.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.57 / $1,052.01 / $1,539.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.46 / $842.36 / $1,220.20
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.95 / $589.37 / $866.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.96 / $679.56 / $1,293.66
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$652.70 / $678.80 / $1,033.59