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South Dakota rates for HCPCS 70486

Computed tomography, maxillofacial area; without contrast material

Facilitymedian $41 · 10th–90th $41$410%50%$41Professionalmedian $98 · 10th–90th $38$2690%10%10th90th$98$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$30.20 / $40.74 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $194.98 / $416.87
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $60.26 / $147.91
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$83.18 / $158.49 / $1,445.44
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $316.23 / $389.05
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$75.86 / $95.50 / $117.49
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$173.78 / $218.78 / $275.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $239.88 / $1,412.54
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$46.77 / $77.62 / $199.53
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$97.72 / $165.96 / $1,230.27
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $275.42 / $309.03
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $87.10 / $100.00
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$177.83 / $190.55 / $208.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $229.09 / $380.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$50.12 / $72.44 / $77.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$114.82 / $162.18 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $257.04 / $346.74
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$46.77 / $77.62 / $107.15
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$107.15 / $177.83 / $257.04
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $295.12 / $295.12
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $91.20 / $91.20
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$173.78 / $204.17 / $204.17