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South Dakota rates for HCPCS 85301

Clotting inhibitors or anticoagulants; antithrombin III, antigen assay

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.16 / $10.16 / $10.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $9.42 / $132.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.54 / $21.54 / $21.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.39 / $19.57 / $24.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.35 / $17.32 / $144.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.49 / $9.73 / $22.25
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.95 / $22.03 / $33.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.95 / $24.00 / $30.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.64 / $25.24 / $29.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.54 / $7.56 / $12.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.81 / $10.81 / $10.81