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South Dakota rates for HCPCS 80171

Gabapentin, whole blood, serum, or plasma

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.37 / $20.37 / $20.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.52 / $20.37 / $20.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.08 / $43.08 / $43.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.78 / $39.17 / $48.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.45 / $24.54 / $102.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.27 / $19.50 / $27.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.96 / $37.18 / $39.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.96 / $36.36 / $56.56
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.67 / $50.60 / $59.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.10 / $13.00 / $26.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.67 / $21.67 / $21.67