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South Dakota rates for HCPCS 77048

Mri Breast W/Out&With Contrast W/Cad Unilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$101.58 / $101.58 / $101.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.20 / $475.00 / $572.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.67 / $800.52 / $1,000.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.58 / $734.23 / $2,291.23
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$311.99 / $311.99 / $311.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$727.28 / $880.48 / $1,072.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.44 / $579.88 / $668.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.40 / $169.09 / $192.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.83 / $725.11 / $1,129.58
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$760.80 / $895.10 / $895.10