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South Dakota rates for HCPCS 69910

Labyrinthectomy; with mastoidectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$975.88 / $975.88 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.61 / $975.88 / $2,848.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,161.55 / $2,231.34 / $2,789.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,170.60 / $1,649.24 / $2,740.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,208.70 / $2,014.50 / $8,240.67
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,702.00 / $2,649.52 / $5,269.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.00 / $2,161.55 / $2,681.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,241.18 / $1,685.18 / $1,921.29
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
$1,208.70 / $2,014.50 / $2,755.56
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,872.40 / $2,202.80 / $2,291.00