go back

South Dakota rates for HCPCS 67875

Temporary closure of eyelids by suture (eg, Frost suture)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $199.53 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $177.83 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $281.84 / $537.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $169.82 / $436.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $275.42 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $398.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $229.09 / $346.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $223.87 / $478.63
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $218.78 / $416.87