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South Dakota rates for HCPCS 78291

Peritoneal-Venous Shunt Patency Test

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$259.25 / $259.25 / $259.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.35 / $259.25 / $259.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.65 / $560.83 / $701.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$242.82 / $369.01 / $598.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.35 / $347.30 / $580.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.33 / $575.11 / $639.21
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.00 / $528.44 / $671.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.37 / $405.12 / $466.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.39 / $347.30 / $673.33
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.70 / $479.60 / $479.60