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South Dakota rates for HCPCS 76101

Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urography; unilateral

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.78 / $229.61 / $287.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$875.23 / $875.23 / $875.23
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.94 / $220.00 / $250.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.00 / $202.00 / $296.85
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.60 / $215.83 / $263.33