go back

South Dakota rates for HCPCS 74174

Ct Angio Abd&Plvis Cntrst Mtrl W/Wo Cntrst Img

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$105.54 / $105.54 / $105.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.58 / $541.83 / $782.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$93.92 / $160.18 / $380.70
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$263.83 / $447.91 / $657.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.95 / $906.02 / $1,132.52
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$192.22 / $235.04 / $293.80
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$548.73 / $670.98 / $838.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.96 / $755.23 / $2,573.48
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$131.25 / $202.34 / $653.20
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$337.55 / $552.89 / $2,038.19
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$339.72 / $339.72 / $339.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$715.46 / $881.52 / $1,078.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.10 / $636.23 / $751.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$134.11 / $178.82 / $200.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$338.08 / $465.77 / $550.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.76 / $755.23 / $870.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$122.63 / $202.34 / $234.10
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$345.13 / $552.89 / $614.36
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.50 / $873.50 / $873.50
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$198.90 / $234.10 / $234.10
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$543.60 / $639.50 / $639.50