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South Dakota rates for HCPCS 80076

Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $109.65 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $10.96 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $15.85 / $19.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $44.67 / $181.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $5.75 / $11.48
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.50 / $22.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $5.75 / $14.13
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13