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South Dakota rates for HCPCS A2008

TheraGenesis, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $147.91 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $169.82 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $181.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $239.88 / $302.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $676.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $169.82 / $204.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $162.18 / $223.87
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18