go back

South Dakota rates for HCPCS 99480

Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.74 / $120.81 / $320.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.96 / $203.21 / $254.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.83 / $172.40 / $234.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.80 / $206.72 / $1,082.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.43 / $219.80 / $231.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.43 / $198.00 / $246.02
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.69 / $194.62 / $254.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.80 / $165.98 / $231.19
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.40 / $237.30 / $237.30