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South Dakota rates for HCPCS 76102

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

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $416.87 / $524.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $288.40 / $380.19