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South Dakota rates for HCPCS 69725

Decompression facial nerve, intratemporal; including medial to geniculate ganglion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,829.98 / $1,829.98 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,536.41 / $1,829.98 / $5,272.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,074.21 / $4,191.56 / $5,239.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,197.07 / $3,092.67 / $4,976.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,215.94 / $3,693.24 / $14,283.70
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,861.15 / $4,610.81 / $5,804.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,882.00 / $4,074.21 / $5,046.56
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,265.77 / $3,145.84 / $3,621.35
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
$2,428.69 / $4,616.55 / $5,152.70
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,529.20 / $4,152.00 / $4,318.10