go back

South Dakota rates for HCPCS 36904

Perq Thrmbc/Nfs Dialysis Circuit Img Dx Angrph

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$381.17 / $2,073.96 / $2,073.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.93 / $1,643.84 / $2,073.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.22 / $3,669.56 / $5,047.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$472.64 / $1,667.20 / $4,730.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,996.26 / $5,036.05 / $13,077.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$883.11 / $3,239.75 / $5,825.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.11 / $3,239.75 / $4,895.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.95 / $2,296.85 / $3,333.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,954.08 / $3,515.17 / $5,468.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.00 / $878.40 / $4,206.89