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South Dakota rates for HCPCS 84022

Assay Of Phenothiazine

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $40.74 / $40.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $40.74 / $51.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $60.26 / $100.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $34.67