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South Dakota rates for HCPCS 72129

Ct Thoracic Spine W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$59.03 / $59.03 / $59.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.46 / $316.26 / $451.52
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.35 / $59.03 / $263.70
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$107.11 / $260.23 / $377.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.14 / $404.92 / $506.14
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.21 / $131.09 / $163.87
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$223.93 / $273.82 / $342.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.01 / $366.93 / $1,884.77
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$73.29 / $112.98 / $434.24
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$164.72 / $253.95 / $1,950.00
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$192.23 / $192.23 / $192.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$368.61 / $489.06 / $593.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.19 / $331.19 / $380.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.23 / $97.59 / $111.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$166.88 / $223.83 / $302.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.91 / $366.93 / $461.64
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.42 / $109.93 / $130.66
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$140.21 / $253.95 / $339.06
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$332.40 / $391.10 / $391.10
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$110.40 / $129.90 / $129.90
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$222.00 / $261.20 / $261.20