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South Dakota rates for HCPCS 74251

Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$56.81 / $56.81 / $56.81
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$111.93 / $111.93 / $111.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.48 / $79.09 / $106.09