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South Dakota rates for HCPCS 65155

Reinsertion Ocular Implt Rnfcmt &/ Attach Muscle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.25 / $1,047.25 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$849.98 / $1,047.25 / $1,695.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,974.18 / $2,214.98 / $2,768.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$849.98 / $1,292.43 / $2,328.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.50 / $1,599.44 / $2,653.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,709.21 / $2,013.98 / $2,777.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,292.24 / $1,986.79 / $2,586.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.95 / $1,384.94 / $1,846.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $7,542.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$925.99 / $1,681.19 / $2,538.37
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,799.90 / $2,202.30 / $2,202.30