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South Dakota rates for HCPCS 81503

Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $851.14 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,737.80 / $2,137.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,023.29 / $4,265.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $537.03 / $4,466.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $2,089.30 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $537.03 / $1,174.90
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25