go back

South Dakota rates for HCPCS 38200

Injection Procedure Splenoportograpy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.41 / $131.41 / $2,290.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.55 / $107.55 / $131.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.95 / $288.27 / $360.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.50 / $204.34 / $349.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.09 / $285.41 / $1,870.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.00 / $320.89 / $398.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.00 / $279.47 / $338.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.22 / $223.08 / $248.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.09 / $271.82 / $375.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.10 / $284.80 / $296.20