go back

South Dakota rates for HCPCS 69505

Mastoidectomy; modified radical

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,231.58 / $1,231.58 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.13 / $1,231.58 / $3,357.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,672.12 / $2,813.33 / $3,516.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,205.18 / $2,081.37 / $3,402.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,431.82 / $2,386.36 / $9,133.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,010.00 / $3,208.49 / $5,269.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,587.00 / $2,685.58 / $3,339.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,482.50 / $2,029.13 / $2,387.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,312.50 / $2,149.07 / $3,343.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,326.30 / $2,736.90 / $2,846.30