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South Dakota rates for HCPCS 0256U

Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile, liquid chromatography tandem mass spectrometry (LC-MS/MS), urine, with algorithmic analysis and interpretive report

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $151.36 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $123.03 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $309.03 / $380.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $154.88 / $758.58
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $190.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $371.54 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $95.50 / $208.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $158.49 / $158.49