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South Dakota rates for HCPCS L8512

Gelatin Capsules Or Equivalent For Use With Tracheoesophageal Voiceprosthesis Replacement Only Per 10

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.20 / $2.20 / $2.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.20 / $2.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.08 / $2.08 / $2.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.96 / $3.72 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.78 / $2.96
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.37 / $2.84 / $4.49
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.33 / $2.88 / $5.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.60 / $3.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $1.70 / $2.79
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.52 / $2.52