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South Dakota rates for HCPCS 77055

Mammogram One Breast

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.50 / $196.25 / $245.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.42 / $139.03 / $191.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$396.65 / $396.65 / $396.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.00 / $145.00 / $145.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.00 / $138.00 / $178.73
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.12 / $146.21 / $176.00