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South Dakota rates for HCPCS 0055U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,045.60 / $3,045.60 / $3,045.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,170.80 / $2,527.19 / $3,045.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,459.46 / $6,459.46 / $6,459.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,653.47 / $5,884.34 / $7,355.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,057.91 / $3,668.65 / $5,947.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,652.40 / $1,944.00 / $7,060.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,181.00 / $5,925.15 / $7,100.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,888.00 / $6,674.40 / $7,100.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,633.20 / $7,806.13 / $8,900.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,360.80 / $1,652.40 / $4,276.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,240.00 / $3,240.00 / $3,240.00