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South Dakota rates for HCPCS 0023U

Oncology (acute myelogenous leukemia), DNA, genotyping of internal tandem duplication, p.D835, p.I836, using mononuclear cells, reported as detection or non-detection of FLT3 mutation and indication for or against the use of midostaurin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $281.84 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $186.21 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $478.63 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $478.63 / $588.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $281.84 / $457.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $147.91 / $1,230.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $295.12 / $295.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $575.44 / $676.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $147.91 / $288.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19