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South Dakota rates for HCPCS 76705

Us Abdominal Real Time W/Image Limited

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$378.11 / $716.01 / $927.90
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$28.52 / $28.52 / $28.52
Aetna
Facility/Professional
Facility
Modifier
TC
Low / Median / High Price
$64.13 / $369.18 / $484.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.31 / $107.68 / $156.62
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.24 / $35.36 / $99.90
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$59.42 / $102.30 / $210.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.97 / $203.23 / $254.04
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.62 / $63.61 / $79.51
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$91.35 / $139.63 / $174.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.77 / $156.58 / $842.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.75 / $169.90 / $568.24
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.13 / $54.15 / $227.85
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$69.23 / $115.75 / $390.02
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.09 / $202.59 / $294.35
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$93.96 / $93.96 / $93.96
Midlands
Facility/Professional
Facility
Modifier
TC
Low / Median / High Price
$260.94 / $260.94 / $260.94
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $202.59 / $225.57
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.55 / $147.52 / $168.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.17 / $47.09 / $53.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$70.33 / $100.43 / $114.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.68 / $121.55 / $184.88
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.03 / $45.57 / $63.56
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$69.23 / $83.12 / $125.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.10 / $181.30 / $181.30
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.20 / $57.90 / $57.90
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$104.90 / $123.50 / $123.50