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South Dakota rates for HCPCS 84165

Protein; electrophoretic fractionation and quantitation, serum

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.57 / $68.95 / $170.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.20 / $9.65 / $57.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.29 / $33.29 / $33.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $33.95 / $42.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.39 / $42.58 / $139.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.44 / $7.51 / $15.01
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.57 / $33.07 / $55.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.72 / $29.11 / $48.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.53 / $25.88 / $29.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $7.51 / $12.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.74 / $10.74 / $10.74