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South Dakota rates for HCPCS 79403

Rp Ther Radiolbld Monoclonal Antibody Iv Infus

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.68 / $197.62 / $277.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.80 / $397.16 / $496.45
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.34 / $345.62 / $435.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.00 / $400.23 / $496.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.83 / $307.74 / $361.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.41 / $250.45 / $386.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.20 / $342.60 / $342.60