go back

South Dakota rates for HCPCS 0072T

Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume greater or equal to 200 cc of tissue

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $549.54 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $562.34 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $912.01 / $2,691.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $2,884.03 / $7,079.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $2,454.71 / $5,248.07