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South Dakota rates for HCPCS 69631

Tympanoplasty W/O Mastoidect W/O Ossicle Recnstj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.09 / $890.09 / $1,652.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$842.36 / $1,139.02 / $3,422.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,937.39 / $2,023.32 / $2,529.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$945.04 / $1,504.25 / $2,466.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,050.08 / $1,750.14 / $7,712.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,420.00 / $2,352.44 / $5,269.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,273.00 / $1,937.39 / $2,419.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,086.79 / $1,477.19 / $1,722.05
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
$1,050.08 / $1,750.14 / $2,447.87
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,678.20 / $1,974.40 / $2,053.40