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South Dakota rates for HCPCS 85175

Clot Lysis Time Whole Blood Dilution

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.14 / $19.14 / $19.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.65 / $19.14 / $19.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.47 / $40.47 / $40.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.54 / $37.21 / $46.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.29 / $19.22 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.19 / $12.22 / $24.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.03 / $26.58 / $37.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.88 / $11.08 / $53.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.06 / $47.57 / $55.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.19 / $8.56 / $20.37
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.37 / $20.37 / $20.37