go back

South Dakota rates for HCPCS 66150

Fistulization of sclera for glaucoma; trephination with iridectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,047.13 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,096.48 / $2,454.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,258.93 / $6,606.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,041.74 / $2,041.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,445.44 / $1,698.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,548.82 / $2,454.71
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,949.84 / $1,995.26