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South Dakota rates for HCPCS 70558

Mri Brain Open Intracranial Px W/Contrast Matl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$169.84 / $169.84 / $169.84
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$516.23 / $516.23 / $516.23
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$201.10 / $274.43 / $322.16