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South Dakota rates for HCPCS 0004M

Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva, prognostic algorithm reported as a risk score

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $74.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $60.26 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $102.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $75.86 / $144.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $47.86 / $398.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $186.21 / $218.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $47.86 / $91.20
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43