go back

South Dakota rates for HCPCS 84120

Porphyrins, urine; quantitation and fractionation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.83 / $50.63 / $97.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.56 / $13.11 / $13.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.38 / $29.38 / $29.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.93 / $26.76 / $33.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.10 / $23.58 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.83 / $13.24 / $30.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.98 / $29.98 / $46.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.98 / $29.02 / $39.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.02 / $34.35 / $40.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.18 / $10.29 / $17.64
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.71 / $14.71 / $14.71