go back

South Dakota rates for HCPCS 84704

Gonadotropin, chorionic (hCG); free beta chain

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.37 / $14.37 / $14.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.24 / $18.01 / $22.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.68 / $30.68 / $30.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.35 / $27.42 / $34.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.64 / $24.13 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.17 / $16.52 / $30.98
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.73 / $30.67 / $47.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.73 / $33.45 / $43.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.94 / $36.84 / $42.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.17 / $15.29 / $20.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.29 / $15.29 / $15.29