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South Dakota rates for HCPCS 84255

Assay Of Selenium

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.00 / $70.38 / $124.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.59 / $22.25 / $69.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.92 / $50.92 / $50.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.32 / $46.35 / $57.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.66 / $28.92 / $169.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.32 / $22.98 / $52.53
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.95 / $46.54 / $52.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.95 / $52.02 / $66.63
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $59.62 / $70.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $17.86 / $30.64
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.53 / $25.53 / $25.53