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South Dakota rates for HCPCS 81375

HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.50 / $207.50 / $207.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.90 / $207.50 / $232.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.99 / $439.99 / $439.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.98 / $400.82 / $501.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.34 / $249.95 / $405.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.44 / $154.43 / $454.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.86 / $483.77 / $619.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.89 / $449.74 / $619.04
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.48 / $531.83 / $606.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.71 / $154.43 / $220.74
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.74 / $220.74 / $220.74