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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
$843.18 / $843.18 / $843.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.99 / $699.66 / $843.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,788.02 / $1,788.02 / $1,788.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.84 / $1,629.39 / $2,036.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$740.52 / $1,015.67 / $4,260.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.47 / $807.30 / $1,644.74
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,157.52 / $1,644.74 / $1,993.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.40 / $1,644.74 / $2,341.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,282.71 / $2,161.14 / $2,464.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$376.74 / $538.20 / $1,076.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$897.00 / $897.00 / $897.00