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South Dakota rates for HCPCS 75989

Radiological Guidance Prq Drg W/Plmt Cath Rs&I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$55.61 / $55.61 / $55.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.58 / $134.19 / $147.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.98 / $256.76 / $320.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.19 / $219.11 / $1,548.00
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$185.14 / $185.14 / $185.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.26 / $264.72 / $325.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.90 / $195.38 / $214.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$71.34 / $93.05 / $106.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.41 / $219.11 / $308.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.60 / $223.00 / $223.00