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South Dakota rates for HCPCS 72202

Radiologic examination, sacroiliac joints; 3 or more views

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $45.71 / $117.49
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.55 / $16.22 / $33.11
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.70 / $34.67 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $93.33 / $117.49
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.50 / $24.55 / $30.90
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.95 / $69.18 / $87.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $52.48 / $93.33
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$10.23 / $18.20 / $33.11
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$23.44 / $37.15 / $181.97
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $77.62 / $83.18
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.88 / $21.88 / $22.91
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.95 / $54.95 / $61.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.99 / $23.99 / $23.99
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.70 / $53.70 / $53.70
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $53.70 / $75.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$11.75 / $15.85 / $20.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$28.84 / $39.81 / $56.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $56.23 / $83.18
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$10.47 / $17.38 / $22.91
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$27.54 / $39.81 / $58.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $79.43 / $79.43
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.20 / $21.38 / $21.38
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$48.98 / $57.54 / $57.54