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South Dakota rates for HCPCS L8040

Nasal prosthesis, provided by a nonphysician

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,506.83 / $2,506.83 / $2,506.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,152.13 / $2,506.83 / $2,752.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,373.71 / $2,373.71 / $3,033.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,469.50 / $3,469.50 / $4,336.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,140.37 / $4,236.54 / $13,967.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,123.06 / $1,875.17 / $3,170.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,522.01 / $3,033.16 / $5,796.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,484.17 / $3,075.84 / $5,796.31
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,351.42 / $2,752.94 / $3,272.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,043.36 / $1,776.73 / $2,343.96
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,702.27 / $2,702.27 / $2,702.27