go back

South Dakota rates for HCPCS 0105U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$893.00 / $893.00 / $893.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$636.50 / $893.00 / $893.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,893.77 / $1,893.77 / $1,893.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,102.47 / $1,725.35 / $2,156.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$896.61 / $1,075.69 / $4,512.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.50 / $855.00 / $1,425.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,140.00 / $1,737.31 / $1,869.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,140.95 / $1,869.31 / $2,479.50
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.00 / $2,288.84 / $2,609.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$399.00 / $570.00 / $1,140.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.00 / $950.00 / $950.00