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South Dakota rates for HCPCS 76497

Unlisted Computed Tomography Procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.72 / $115.72 / $115.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.42 / $100.42 / $115.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,173.00 / $1,173.00 / $1,173.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.83 / $395.61 / $494.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.42 / $169.71 / $211.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.77 / $661.49 / $661.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.00 / $233.85 / $285.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.47 / $232.69 / $283.20