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South Dakota rates for HCPCS 72084

Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$19.95 / $19.95 / $19.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $117.49 / $229.09
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.05 / $26.92 / $69.18
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.57 / $83.18 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $234.42 / $295.12
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.15 / $46.77 / $58.88
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$147.91 / $190.55 / $234.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $120.23 / $204.17
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.42 / $30.90 / $57.54
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.66 / $91.20 / $173.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $199.53 / $208.93
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.81 / $42.66 / $48.98
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$147.91 / $151.36 / $165.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.66 / $42.66 / $42.66
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$147.91 / $147.91 / $147.91
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $158.49 / $190.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.44 / $33.88 / $38.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $128.82 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $138.04 / $208.93
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.39 / $32.36 / $43.65
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.61 / $102.33 / $169.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $199.53 / $199.53
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.67 / $40.74 / $40.74
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.90 / $158.49 / $158.49