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South Dakota rates for HCPCS 84704

Gonadotropin, chorionic (hCG); free beta chain

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $14.13 / $17.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $14.13 / $41.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $28.84 / $28.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $28.84 / $36.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.45 / $23.44 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $16.60 / $20.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $37.15 / $41.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $16.60 / $20.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14