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South Dakota rates for HCPCS 21193

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,248.00 / $1,248.00 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,040.10 / $1,248.00 / $2,011.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,159.98 / $2,811.77 / $3,514.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,636.32 / $2,045.04 / $3,150.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,189.72 / $2,443.88 / $14,942.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,810.79 / $2,853.38 / $3,785.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,810.79 / $2,571.23 / $3,295.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,465.55 / $2,021.00 / $2,394.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,189.72 / $2,252.88 / $3,504.48
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,375.80 / $2,906.80 / $2,906.80