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South Dakota rates for HCPCS 0108U

Gastroenterology (Barrett's esophagus), whole slide-digital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, AMACR, p53, CD68, COX-2, CD45RO, HIF1a, HER-2, K20) and morphology, formalin-fixed paraffin-embedded tissue, algorithm reported as risk of progression to high-grade dysplasia or cancer

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $5,888.44 / $11,748.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,623.41 / $5,623.41 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,513.56 / $24,547.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,128.31 / $12,882.50 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $2,089.30 / $4,897.79
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $4,897.79