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South Dakota rates for HCPCS 67912

Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$514.00 / $988.75 / $988.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$454.01 / $1,059.34 / $2,170.67
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,123.90 / $1,795.50 / $2,408.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.92 / $1,137.58 / $1,694.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00