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South Dakota rates for HCPCS 0093U

Prescription drug monitoring, evaluation of 65 common drugs by LC-MS/MS, urine, each drug reported detected or not detected

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $47.86 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $120.23 / $147.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $70.79 / $295.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $31.62 / $74.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $144.54 / $169.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $37.15 / $81.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66