go back

South Dakota rates for HCPCS E1230

Power operated vehicle (three- or four-wheel nonhighway), specify brand name and model number

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,160.28 / $2,917.67 / $2,917.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,786.79 / $1,786.79 / $3,476.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,663.75 / $3,700.39 / $4,579.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,159.58 / $4,137.45 / $14,043.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.97 / $2,233.48 / $2,627.63
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.27 / $341.89 / $341.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.89 / $653.32 / $3,612.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,049.28 / $2,233.48 / $2,627.63
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,844.17 / $2,844.17 / $2,844.17