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South Dakota rates for HCPCS 74355

Percutaneous Placement Enteroclysis Tube Rs&I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.16 / $137.16 / $137.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.59 / $137.16 / $142.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.42 / $353.72 / $442.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.20 / $218.03 / $267.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.31 / $86.56 / $854.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.23 / $263.00 / $357.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.84 / $275.41 / $350.34
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.91 / $161.91 / $161.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.37 / $80.52 / $185.48
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.10 / $261.30 / $261.30