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South Dakota rates for HCPCS 81509

Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG [any form], DIA), utilizing maternal serum, algorithm reported as a risk score

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,398.13 / $1,398.13 / $1,398.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$996.54 / $1,398.13 / $1,398.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,965.02 / $2,965.02 / $2,965.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,708.99 / $2,701.29 / $3,376.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.61 / $1,403.77 / $7,065.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.56 / $1,338.63 / $2,231.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,784.84 / $2,727.24 / $2,831.55
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,786.32 / $2,831.55 / $3,882.04
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,487.37 / $3,583.52 / $4,086.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$624.70 / $892.42 / $1,784.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,487.37 / $1,487.37 / $1,487.37