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South Dakota rates for HCPCS 77402

Radiation Treatment Delivery 1 Mev+ Simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.05 / $137.05 / $137.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.62 / $114.62 / $137.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.21 / $307.18 / $383.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.11 / $193.71 / $312.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.09 / $258.14 / $315.99
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.90 / $282.94 / $415.49
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.00 / $302.64 / $377.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.92 / $169.87 / $319.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.38 / $172.09 / $292.42
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.00 / $283.50 / $283.50