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South Dakota rates for HCPCS 0004M

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.30 / $55.30 / $158.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.50 / $94.80 / $103.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.56 / $89.45 / $145.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $47.40 / $154.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.94 / $150.40 / $202.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.80 / $153.34 / $173.14
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.97 / $190.33 / $217.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.18 / $40.29 / $79.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.00 / $79.00 / $79.00