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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
$1,960.34 / $1,960.34 / $1,960.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,688.25 / $5,940.00 / $11,238.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,604.89 / $5,604.89 / $7,863.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,281.76 / $2,261.92 / $24,651.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,243.18 / $5,508.00 / $12,672.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,945.91 / $5,508.00 / $5,940.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,137.11 / $11,926.04 / $13,598.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,507.95 / $2,079.00 / $4,950.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,950.00 / $4,950.00 / $4,950.00