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Myelogram Of The Lower Back, Injection And X-ray Imaging

South Dakota rates for HCPCS 62304

A dye study of the lower back and tailbone portion of the spine. Contrast dye is injected through a needle into the fluid-filled space around the spinal cord and nerve roots, and x-ray images are then taken and interpreted. The injection and the imaging are both part of this service.

Rates data updated July 2026.

Facilitymedian $363 · 10th–90th $162$2,2910%10%10th90th$363Professionalmedian $224 · 10th–90th $112$5750%20%10th90th$224$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$1,513.56
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$112.20
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$407.38
Typical High
$741.31
Medica
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$288.40
Typical High
$537.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$467.74
Typical High
$954.99
Midlands
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$436.52
Typical High
$616.60
Midlands
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$436.52
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$346.74
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$302.00
Typical High
$602.56
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$245.47
Typical High
$588.84