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South Dakota rates for HCPCS 81313

Pca3/Klk3 Prostate Specific Antigen Ratio

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.75 / $239.75 / $239.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.88 / $198.94 / $239.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.53 / $508.53 / $508.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.02 / $462.84 / $578.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.71 / $288.79 / $468.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.66 / $153.03 / $467.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.12 / $467.65 / $558.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.06 / $427.98 / $558.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.72 / $614.49 / $700.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.12 / $133.66 / $229.55
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.05 / $255.05 / $255.05