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South Dakota rates for HCPCS 50684

Inj Px Ureterography/Ureteropylography Cath

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.47 / $127.78 / $127.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.87 / $112.78 / $127.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.78 / $173.36 / $365.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.14 / $162.01 / $314.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.43 / $232.44 / $3,402.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.36 / $236.82 / $400.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.18 / $209.71 / $337.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.58 / $167.58 / $241.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.51 / $214.02 / $331.77
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.50 / $119.40 / $293.70