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South Dakota rates for HCPCS 72084

Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 6/> Vw

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$20.58 / $20.58 / $20.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.54 / $88.91 / $166.90
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$17.50 / $20.81 / $71.09
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$59.64 / $71.42 / $135.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.59 / $231.16 / $288.95
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.43 / $45.77 / $57.21
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$136.50 / $185.39 / $231.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.98 / $168.97 / $637.19
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.46 / $38.54 / $127.82
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$72.52 / $120.88 / $509.36
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$81.50 / $81.50 / $81.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.05 / $198.07 / $249.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.98 / $162.22 / $190.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.62 / $33.31 / $38.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$80.65 / $129.22 / $152.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.98 / $138.58 / $173.66
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.57 / $32.61 / $40.76
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$84.41 / $120.88 / $151.10
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.40 / $198.20 / $198.20
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.29 / $40.29 / $40.29
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.19 / $157.80 / $157.80