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South Dakota rates for HCPCS 76604

Us Chest Real Time W/Image Documentation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$27.81 / $27.81 / $27.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.05 / $88.15 / $127.89
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.87 / $27.36 / $75.65
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$25.53 / $25.53 / $77.16
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$27.38 / $63.28 / $91.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.68 / $134.19 / $167.75
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.09 / $61.28 / $76.59
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$55.82 / $72.92 / $91.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.73 / $147.19 / $447.95
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$29.68 / $53.48 / $265.83
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$60.79 / $93.72 / $398.99
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$86.74 / $86.74 / $86.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.00 / $161.82 / $198.38
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.07 / $106.94 / $144.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.15 / $44.54 / $52.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.85 / $60.16 / $99.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.30 / $129.58 / $178.42
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$29.68 / $36.60 / $54.64
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$36.34 / $74.67 / $124.46
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.20 / $121.40 / $121.40
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.00 / $56.50 / $56.50
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$55.10 / $64.90 / $64.90