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South Dakota rates for HCPCS 69641

Tmpp Mastoidectomy W/O Ossicular Chain Recnstj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,037.36 / $1,037.36 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,186.18 / $1,753.16 / $2,889.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,705.00 / $2,770.62 / $5,269.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,280.98 / $1,739.44 / $2,018.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00