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South Dakota rates for HCPCS 0174U

Oncology (solid tumor), mass spectrometric 30 protein targets, formalin-fixed paraffin-embedded tissue, prognostic and predictive algorithm reported as likely, unlikely, or uncertain benefit of 39 chemotherapy and targeted therapeutic oncology agents

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,479.11 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,000.00 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,511.89 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,479.11 / $6,165.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $1,548.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $3,019.95 / $3,548.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $776.25 / $1,737.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $1,318.26