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South Dakota rates for HCPCS 75870

Venography Superior Sagittal Sinus Rs&I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.57 / $161.57 / $161.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.60 / $137.60 / $161.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.67 / $376.21 / $470.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.39 / $232.54 / $681.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.65 / $314.39 / $3,097.70
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.41 / $372.33 / $549.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.91 / $398.73 / $598.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.74 / $270.55 / $318.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.14 / $299.42 / $361.06
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.89 / $330.50 / $330.50