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South Dakota rates for HCPCS 67902

Rpr Blepharopt Frontalis Musc Autol Fascal Sling

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$769.99 / $769.99 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.05 / $769.99 / $1,264.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,505.92 / $1,657.15 / $2,071.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$631.05 / $962.13 / $1,902.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.86 / $1,299.28 / $2,264.59
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,151.56 / $1,674.29 / $2,380.56
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$945.00 / $1,674.29 / $1,916.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.25 / $1,184.48 / $1,393.42
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
$752.99 / $1,307.42 / $2,021.10
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,358.00 / $1,661.50 / $1,661.50