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South Dakota rates for HCPCS 0122U

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.57 / $352.57 / $352.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,049.05 / $1,049.05 / $1,049.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$610.67 / $955.70 / $1,194.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.65 / $595.84 / $2,499.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.38 / $473.61 / $789.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$631.48 / $962.34 / $1,035.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.99 / $1,035.58 / $1,373.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.23 / $1,267.84 / $1,445.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.02 / $315.74 / $526.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.23 / $526.23 / $526.23