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South Dakota rates for HCPCS 81208

BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.74 / $201.74 / $201.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.80 / $167.40 / $201.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.58 / $427.58 / $427.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.20 / $389.72 / $487.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.56 / $243.02 / $394.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.52 / $128.77 / $393.53
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$276.95 / $393.53 / $470.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.54 / $393.53 / $470.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.66 / $501.16 / $589.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.14 / $112.52 / $214.62
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.62 / $214.62 / $214.62