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South Dakota rates for HCPCS 67141

Proph Retinal Dtchmnt W/O Drg Crtx Diathermy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.98 / $291.02 / $291.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.76 / $439.33 / $576.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.95 / $620.36 / $777.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.39 / $341.54 / $1,280.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.45 / $1,044.20 / $2,839.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$280.19 / $653.86 / $1,128.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.50 / $830.81 / $1,214.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.42 / $439.37 / $850.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.54 / $1,044.20 / $1,471.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.20 / $495.20 / $616.29