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South Dakota rates for HCPCS L8684

Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$855.02 / $855.02 / $855.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.45 / $855.02 / $936.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.69 / $510.69 / $1,122.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,183.50 / $1,183.50 / $1,479.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$697.34 / $1,444.98 / $3,998.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.10 / $637.99 / $1,166.50
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.33 / $1,122.50 / $1,568.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.77 / $1,138.28 / $2,145.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$800.04 / $936.64 / $1,113.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.26 / $614.34 / $970.01
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$918.41 / $918.41 / $918.41