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South Dakota rates for HCPCS 81350

UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia [Gilbert syndrome]) gene analysis, common variants (eg, *28, *36, *37)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.96 / $219.96 / $219.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.78 / $182.52 / $219.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$466.75 / $466.75 / $466.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.08 / $424.97 / $531.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.57 / $264.95 / $371.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.34 / $140.40 / $429.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$301.95 / $429.06 / $520.01
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.80 / $429.06 / $512.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.62 / $563.78 / $642.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.28 / $119.34 / $234.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.00 / $234.00 / $234.00