go back

South Dakota rates for HCPCS 77762

Intracavitary radiation source application; intermediate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $575.44 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $588.84 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,348.96 / $1,659.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $831.76 / $1,348.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $676.08 / $1,202.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $912.01 / $1,096.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $812.83 / $1,258.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,230.27 / $1,230.27