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South Dakota rates for HCPCS 67400

Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $3,548.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,148.15 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,398.83 / $3,019.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,318.26 / $2,570.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,412.54 / $7,762.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,238.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,698.24 / $2,630.27
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,238.72 / $2,344.23