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South Dakota rates for HCPCS 89264

Sprm Id From Tstis Tiss Frsh/Cryoprsrvd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$299.83 / $299.83 / $299.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.83 / $365.38 / $381.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.99 / $172.99 / $172.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.54 / $172.99 / $216.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$428.77 / $545.76 / $1,253.70
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.15 / $180.15 / $180.15
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.40 / $53.40 / $53.40