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South Dakota rates for HCPCS 80415

Chornc Gonad Stimj Pnl Total Estradiol Response

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.54 / $52.54 / $52.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.45 / $52.54 / $52.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.63 / $111.63 / $111.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.43 / $101.84 / $127.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.55 / $89.60 / $265.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.53 / $50.30 / $114.99
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.12 / $113.85 / $175.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.12 / $117.82 / $152.94
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.26 / $130.51 / $153.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.47 / $50.30 / $67.06
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.89 / $55.89 / $55.89