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South Dakota rates for HCPCS 75572

Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)

Facilitymedian $83 · 10th–90th $62–$830%50%10th$83Professionalmedian $214 · 10th–90th $79–$4570%5%10%10th90th$214$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$61.66 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $323.59
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$72.44 / $83.18 / $123.03
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$138.04 / $181.97 / $223.87
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $416.87 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $549.54 / $691.83
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$151.36 / $190.55 / $239.88
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$288.40 / $363.08 / $457.09
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $426.58 / $812.83
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$87.10 / $128.82 / $245.47
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $295.12 / $562.34
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $489.78 / $588.84
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$165.96 / $173.78 / $204.17
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$295.12 / $323.59 / $398.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $436.52 / $467.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$100.00 / $141.25 / $158.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $288.40 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $467.74 / $645.65
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$93.33 / $154.88 / $223.87
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$181.97 / $295.12 / $436.52
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $524.81 / $524.81
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$154.88 / $186.21 / $186.21
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$288.40 / $338.84 / $338.84