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South Dakota rates for HCPCS 0496T

Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; each additional hour (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.87 / $241.87 / $241.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.81 / $241.87 / $241.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.04 / $339.04 / $339.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.64 / $400.21 / $648.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.01 / $513.08 / $1,846.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.67 / $372.84 / $431.73
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.04 / $372.84 / $457.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.19 / $530.57 / $720.36