go back

South Dakota rates for HCPCS G0414

Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $4,365.16 / $5,623.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,548.82 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,548.82 / $2,089.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,698.24 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $5,370.32