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South Dakota rates for HCPCS 81422

Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$713.51 / $713.51 / $713.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.56 / $592.05 / $713.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.19 / $1,513.19 / $1,513.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$872.26 / $1,378.71 / $1,723.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$716.39 / $859.47 / $3,605.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.19 / $683.15 / $1,391.79
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$979.50 / $1,391.79 / $1,663.52
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$910.86 / $1,391.79 / $1,981.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$962.80 / $1,828.78 / $2,085.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.80 / $455.43 / $802.33
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.05 / $759.05 / $759.05