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South Dakota rates for HCPCS 67440

Orbitotomy Bone Flap/Window Lateral W/Drg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,452.76 / $1,452.76 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,179.50 / $1,452.76 / $2,357.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,764.33 / $3,067.32 / $3,834.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,179.50 / $1,694.35 / $3,159.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.18 / $2,283.82 / $3,788.59
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,448.65 / $2,849.14 / $3,520.16
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,847.38 / $2,833.44 / $3,592.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,355.49 / $1,976.74 / $2,561.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,322.21 / $2,442.73 / $3,437.75
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,495.90 / $3,053.80 / $3,053.80