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South Dakota rates for HCPCS 76817

Us Preg Uterus Real Time W/Image Dcmtn Transvag

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$36.59 / $36.59 / $36.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.15 / $141.91 / $258.99
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.04 / $57.29 / $132.60
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.47 / $89.30 / $455.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.58 / $214.87 / $268.58
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.29 / $81.45 / $101.81
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$87.29 / $133.41 / $166.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.05 / $178.58 / $600.27
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.84 / $69.50 / $233.19
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.48 / $109.08 / $372.64
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$118.96 / $118.96 / $118.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.00 / $203.95 / $236.60
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.05 / $156.04 / $177.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.81 / $60.14 / $68.56
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.58 / $95.89 / $109.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.05 / $129.32 / $206.79
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.84 / $49.80 / $79.87
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.48 / $79.79 / $120.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.00 / $191.80 / $191.80
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.80 / $73.90 / $73.90
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$100.20 / $117.90 / $117.90