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South Dakota rates for HCPCS 75571

Ct Heart No Contrast Quant Eval Coronry Calcium

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$28.17 / $28.17 / $28.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.48 / $80.83 / $171.78
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.24 / $25.35 / $42.49
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$48.13 / $52.94 / $129.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.02 / $239.69 / $299.61
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.38 / $62.83 / $78.54
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.68 / $176.86 / $221.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.69 / $195.27 / $659.39
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.54 / $53.49 / $173.89
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$87.15 / $141.78 / $485.50
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$88.47 / $88.47 / $88.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.89 / $201.74 / $281.02
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.00 / $168.27 / $197.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.18 / $46.85 / $53.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$87.42 / $123.18 / $144.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.63 / $189.99 / $212.96
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.35 / $52.04 / $60.44
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$80.48 / $137.94 / $153.22
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.40 / $231.00 / $231.00
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.60 / $61.90 / $61.90
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$143.80 / $169.10 / $169.10