go back

South Dakota rates for HCPCS 90965

End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.43 / $536.57 / $536.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.75 / $866.37 / $1,268.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$471.75 / $906.80 / $1,148.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.08 / $792.54 / $3,624.69
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$683.47 / $1,032.25 / $1,229.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.95 / $909.13 / $1,155.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.26 / $742.08 / $961.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.48 / $746.05 / $1,244.24
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.40 / $1,121.20 / $1,121.20