go back

South Dakota rates for HCPCS 80426

Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $114.82 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $281.84 / $354.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $204.17 / $562.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $104.71 / $208.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $389.05 / $407.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $104.71 / $257.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $147.91