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South Dakota rates for HCPCS 80155

Caffeine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.26 / $36.26 / $36.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.84 / $36.26 / $36.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.03 / $77.03 / $77.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.19 / $69.84 / $87.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.69 / $43.67 / $183.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.89 / $29.10 / $46.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.35 / $50.35 / $70.73
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.35 / $46.32 / $100.67
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.50 / $90.06 / $105.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.89 / $29.10 / $38.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.57 / $38.57 / $38.57