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South Dakota rates for HCPCS 49491

Rpr 1st Ingun Hrna Preterm Inft Rdc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$722.96 / $722.96 / $722.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.03 / $705.15 / $722.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.54 / $1,731.16 / $2,163.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$781.82 / $1,216.78 / $2,064.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$844.91 / $1,494.18 / $7,231.97
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,163.08 / $1,777.73 / $2,494.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,108.00 / $1,764.18 / $2,152.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$856.47 / $1,252.07 / $1,568.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$844.91 / $1,464.88 / $2,148.94
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.60 / $1,903.30 / $1,903.30