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South Dakota rates for HCPCS 67345

Chemodenervation Extraocular Muscle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.44 / $255.02 / $255.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.79 / $251.74 / $371.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.58 / $552.38 / $690.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.79 / $312.30 / $606.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.71 / $476.18 / $1,592.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.81 / $528.39 / $654.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.00 / $534.20 / $644.94
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.31 / $394.50 / $474.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.89 / $432.70 / $673.09
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.70 / $503.70 / $566.20