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South Dakota rates for HCPCS 0121U

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.44 / $356.44 / $859.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,015.10 / $1,015.10 / $1,015.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.07 / $925.02 / $1,156.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.58 / $576.55 / $2,418.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.69 / $458.28 / $763.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$611.04 / $931.20 / $1,002.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.54 / $1,002.07 / $1,329.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.20 / $1,226.82 / $1,398.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.86 / $458.28 / $672.14
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.20 / $509.20 / $509.20