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South Dakota rates for HCPCS 75880

Venography Orbital Rs&I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.68 / $113.68 / $113.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.72 / $96.72 / $113.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.17 / $252.10 / $315.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.77 / $163.46 / $309.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.56 / $221.32 / $1,021.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.22 / $250.06 / $365.68
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.33 / $270.14 / $282.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.85 / $183.27 / $239.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.79 / $215.33 / $311.41
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.40 / $217.00 / $217.00