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South Dakota rates for HCPCS 73201

Computed tomography, upper extremity; with contrast material(s)

Facilitymedian $56 · 10th–90th $56$560%50%$56Professionalmedian $178 · 10th–90th $54$4470%5%10th90th$178$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$39.81 / $56.23 / $56.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $645.65
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $58.88 / $154.88
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$138.04 / $177.83 / $363.08
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $489.78 / $616.60
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$102.33 / $128.82 / $158.49
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$288.40 / $363.08 / $446.68
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $338.84 / $1,621.81
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $93.33 / $346.74
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$165.96 / $281.84 / $1,318.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $436.52 / $501.19
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $114.82 / $134.90
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$295.12 / $316.23 / $363.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $371.54 / $426.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$67.61 / $91.20 / $104.71
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $269.15 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $389.05 / $562.34
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $97.72 / $144.54
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$181.97 / $302.00 / $416.87
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $457.09
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $123.03 / $123.03
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$288.40 / $338.84 / $338.84