go back

South Dakota rates for HCPCS 84376

Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $5.01 / $6.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $4.79 / $6.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.23 / $10.23 / $10.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $10.23 / $12.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $8.51 / $69.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $3.31 / $5.50
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $12.88 / $15.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $3.31 / $7.24
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $5.50 / $5.50