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South Dakota rates for HCPCS 74150

Computed tomography, abdomen; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$40.74 / $57.54 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $190.55 / $467.74
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.70 / $79.43 / $194.98
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$77.62 / $112.20 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $331.13 / $416.87
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.71 / $131.83 / $162.18
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$162.18 / $199.53 / $251.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $251.19 / $457.09
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.26 / $100.00 / $165.96
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$91.20 / $154.88 / $1,659.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $295.12 / $331.13
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.20 / $117.49 / $138.04
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$162.18 / $177.83 / $194.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $309.03
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$123.03 / $123.03 / $123.03
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$181.97 / $181.97 / $181.97
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $245.47 / $346.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.18 / $93.33 / $107.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$107.15 / $151.36 / $269.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $257.04 / $371.54
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$58.88 / $100.00 / $128.82
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$100.00 / $162.18 / $234.42
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $316.23 / $316.23
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.15 / $125.89 / $125.89
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$158.49 / $186.21 / $186.21