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South Dakota rates for HCPCS 66179

Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.20 / $1,148.20 / $1,148.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$811.78 / $1,352.95 / $3,012.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,019.46 / $2,502.01 / $4,970.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,244.05 / $1,768.45 / $2,073.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00