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South Dakota rates for HCPCS 0169U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$438.20 / $438.20 / $438.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.61 / $438.20 / $438.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$929.59 / $929.59 / $929.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.58 / $846.68 / $1,058.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.97 / $527.84 / $855.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.75 / $279.70 / $917.39
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$559.40 / $606.02 / $1,021.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.40 / $852.51 / $1,021.65
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.62 / $1,123.14 / $1,280.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.79 / $237.75 / $466.17
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.17 / $466.17 / $466.17