go back

South Dakota rates for HCPCS 84376

Sugars Mono Di&Oligos 1 Qualitataive Each Spec

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.17 / $5.17 / $5.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.69 / $4.79 / $5.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.10 / $11.10 / $11.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.20 / $9.78 / $12.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.28 / $8.82 / $69.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.75 / $4.95 / $6.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.09 / $11.20 / $17.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $11.60 / $15.51
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.19 / $12.84 / $15.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.75 / $3.30 / $5.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $5.50 / $5.50