go back

South Dakota rates for HCPCS 76885

Us Inft Hips R-T Img Dynamic Req Phys/Qhp Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.81 / $751.23 / $857.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.65 / $110.65 / $211.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.55 / $315.70 / $394.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.53 / $187.00 / $303.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.16 / $261.45 / $740.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.00 / $248.72 / $426.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.00 / $221.20 / $349.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.30 / $228.66 / $260.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.58 / $261.45 / $323.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.90 / $281.10 / $281.10