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South Dakota rates for HCPCS 72110

Radiologic examination, spine, lumbosacral; minimum of 4 views

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$12.02 / $12.02 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $61.66 / $151.36
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$12.02 / $15.85 / $48.98
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$36.31 / $58.88 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $125.89 / $154.88
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.44 / $29.51 / $36.31
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$75.86 / $95.50 / $120.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $72.44 / $138.04
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$15.14 / $23.99 / $53.70
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$33.11 / $51.29 / $295.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $112.20 / $112.20
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.12 / $26.92 / $36.31
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$75.86 / $77.62 / $83.18
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.92 / $26.92 / $26.92
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$72.44 / $72.44 / $72.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $81.28 / $100.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$16.22 / $22.91 / $26.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$39.81 / $57.54 / $75.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $83.18 / $114.82
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$14.79 / $23.44 / $33.88
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$38.90 / $56.23 / $83.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $104.71 / $104.71
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.88 / $25.70 / $25.70
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.61 / $79.43 / $79.43