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South Dakota rates for HCPCS 76514

Ophthalmic Us Dx Corneal Pachymetry Uni/Bi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.52 / $51.55 / $268.13
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$7.85 / $7.85 / $7.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.28 / $13.26 / $39.11
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$7.24 / $8.83 / $11.79
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$3.14 / $4.44 / $6.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.39 / $24.82 / $31.03
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$11.28 / $17.07 / $21.33
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$5.13 / $7.76 / $9.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.90 / $18.98 / $27.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.75 / $21.85 / $1,428.44
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.68 / $14.93 / $1,274.28
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$4.47 / $6.92 / $988.10
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.09 / $26.33 / $38.50
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$31.22 / $31.22 / $31.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.71 / $28.20 / $30.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.76 / $19.29 / $24.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.98 / $13.05 / $16.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$5.03 / $6.46 / $8.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.45 / $21.26 / $30.74
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.19 / $10.81 / $19.66
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$4.38 / $6.31 / $10.34
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.20 / $23.70 / $23.70
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$13.60 / $16.00 / $16.00
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$6.50 / $7.70 / $7.70