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South Dakota rates for HCPCS 51725

Simple Cystometrogram

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$71.66 / $71.66 / $71.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.37 / $289.14 / $719.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.05 / $482.26 / $602.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.47 / $394.57 / $1,687.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.97 / $458.23 / $616.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.47 / $341.49 / $401.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$94.72 / $127.10 / $144.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.68 / $394.57 / $600.77
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.50 / $468.90 / $487.60