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South Dakota rates for HCPCS 90957

End-stage renal disease (ESRD) related services monthly, for patients 12-19 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
$602.91 / $826.11 / $1,186.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.01 / $1,277.99 / $1,948.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$726.23 / $1,396.13 / $1,640.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.21 / $1,122.60 / $5,409.99
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$971.30 / $1,492.43 / $1,894.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$918.93 / $1,297.65 / $1,643.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.95 / $1,073.61 / $1,479.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.94 / $1,122.60 / $1,517.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,409.40 / $1,724.40 / $1,724.40