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South Dakota rates for HCPCS 65779

Placement of amniotic membrane on the ocular surface; single layer, sutured

Facilitymedian $1,259 · 10th–90th $151–$4,3650%10%20%10th90th$1,259Professionalmedian $1,047 · 10th–90th $155–$2,1380%10%10th90th$1,047$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$154.88 / $1,258.93 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $954.99 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $302.00 / $3,388.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $794.33 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,949.84 / $4,265.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $2,630.27 / $2,754.23
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $1,584.89 / $2,137.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $1,047.13 / $3,162.28
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $239.88 / $2,570.40