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South Dakota rates for HCPCS 77065

Diagnostic Mammography Computer-Aided Detcj Uni

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.04 / $39.04 / $39.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.52 / $105.02 / $210.95
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.00 / $57.09 / $126.38
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$85.15 / $151.87 / $443.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.06 / $294.77 / $368.46
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$71.05 / $86.88 / $108.60
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$170.01 / $207.89 / $259.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.37 / $249.84 / $810.58
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.50 / $75.33 / $242.65
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$111.45 / $174.51 / $567.92
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$131.74 / $131.74 / $131.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.60 / $297.83 / $342.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.44 / $213.91 / $243.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.81 / $64.68 / $73.75
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$94.06 / $149.22 / $170.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.19 / $213.82 / $267.27
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.54 / $75.33 / $81.38
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$104.65 / $137.16 / $189.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.30 / $273.30 / $273.30
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.30 / $82.60 / $82.60
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$162.10 / $190.70 / $190.70