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South Dakota rates for HCPCS L8047

Nasal septal prosthesis, provided by a nonphysician

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,391.83 / $1,391.83 / $1,391.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.02 / $1,391.83 / $1,528.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$926.75 / $926.75 / $1,684.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,926.38 / $1,945.64 / $2,407.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,188.49 / $2,352.19 / $7,755.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.62 / $1,041.25 / $1,760.25
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,400.40 / $1,684.23 / $3,218.52
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,379.38 / $1,707.92 / $3,218.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,305.71 / $1,528.66 / $1,817.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.35 / $986.56 / $1,760.25
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,500.50 / $1,500.50 / $1,500.50