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South Dakota rates for HCPCS 0215U

Rare diseases (constitutional/heritable disorders), whole exome and mitochondrial DNA sequence analysis, including small sequence changes, deletions, duplications, short tandem repeat gene expansions, and variants in non-uniquely mappable regions, blood or saliva, identification and categorization of genetic variants, each comparator exome (eg, parent, sibling)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,951.21 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,949.84 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,630.78 / $4,897.79 / $6,165.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $4,677.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,548.82 / $12,882.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,090.30 / $3,090.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $6,025.60 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,548.82 / $2,951.21
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40