go back

South Dakota rates for HCPCS 19030

Injection procedure only for mammary ductogram or galactogram

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.33 / $164.63 / $164.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.50 / $202.70 / $355.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.57 / $251.33 / $515.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.48 / $208.52 / $313.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00