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South Dakota rates for HCPCS 73219

Mri Upper Extremity Oth Than Jt W/Contr Matrl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$78.44 / $78.44 / $78.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.20 / $311.20 / $546.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$644.53 / $788.11 / $985.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.50 / $728.44 / $3,350.26
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$256.31 / $256.31 / $256.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.77 / $875.18 / $1,060.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.55 / $616.44 / $681.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$99.90 / $129.37 / $147.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.64 / $728.44 / $881.26
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$746.70 / $878.40 / $878.40