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South Dakota rates for HCPCS 61651

Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.57 / $221.57 / $221.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.82 / $322.38 / $586.78
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.59 / $581.05 / $742.51
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.16 / $413.52 / $486.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00