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South Dakota rates for HCPCS 90954

End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional per month

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$751.97 / $1,078.88 / $1,540.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.86 / $1,662.42 / $2,535.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$947.85 / $1,823.31 / $2,133.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.52 / $1,416.10 / $6,762.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,229.04 / $1,889.75 / $2,477.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,149.74 / $1,633.21 / $2,061.85
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$990.96 / $1,362.08 / $1,928.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.52 / $1,445.87 / $2,297.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,837.00 / $2,247.69 / $2,247.69