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South Dakota rates for HCPCS 65780

Ocular surface reconstruction; amniotic membrane transplantation, multiple layers

Facilitymedian $1,047 · 10th–90th $676–$4,8980%20%10th90th$1,047Professionalmedian $1,000 · 10th–90th $676–$1,7380%10%20%10th90th$1,000$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
$707.95 / $4,365.16 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $724.44 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,380.38 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $870.96 / $2,454.71
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,071.52 / $2,089.30
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,548.82 / $1,548.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,122.02 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $7,943.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,202.26 / $1,862.09
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,348.96 / $1,348.96