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South Dakota rates for HCPCS 0042T

Cerebral perfusion analysis using computed tomography with contrast administration, including post-processing of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.13 / $97.13 / $121.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.97 / $231.24 / $464.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.43 / $686.70 / $1,779.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.15 / $239.47 / $689.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.06 / $667.12 / $689.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.63 / $686.70 / $794.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.39 / $287.39 / $287.39