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South Dakota rates for HCPCS 42804

Biopsy Nasopharynx Visible Lesion Simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.80 / $213.59 / $213.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.12 / $200.56 / $221.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.38 / $356.44 / $625.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.18 / $269.01 / $510.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.48 / $413.39 / $1,608.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.49 / $450.71 / $2,389.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.00 / $332.68 / $530.57
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.90 / $268.19 / $413.94
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
$231.48 / $413.39 / $559.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.40 / $292.89 / $504.90