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South Dakota rates for HCPCS 65855

Trabeculoplasty by laser surgery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $295.12 / $3,090.30
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $295.12 / $616.60
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$295.12 / $741.31 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $575.44 / $724.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $309.03 / $831.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $467.74 / $4,466.84
Medica
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$831.76 / $831.76 / $831.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $478.63 / $575.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $398.11 / $537.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $407.38 / $660.69
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $467.74 / $562.34