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South Dakota rates for HCPCS 69642

Tmpp Mastoidectomy W/Ossicular Chain Recnstj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,328.28 / $1,328.28 / $5,552.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,550.27 / $2,244.79 / $3,706.10
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,209.00 / $3,560.07 / $5,269.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,646.84 / $2,235.51 / $2,589.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00