go back

South Dakota rates for HCPCS 74190

Peritoneogram Rs&I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.19 / $22.19 / $22.19
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$76.67 / $76.67 / $76.67
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.41 / $36.88 / $42.05