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South Dakota rates for HCPCS 86051

Aquaporin-4 (neuromyelitis optica [NMO]) antibody; enzyme-linked immunosorbent immunoassay (ELISA)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.84 / $10.84 / $10.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.73 / $10.13 / $10.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.22 / $20.89 / $26.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.88 / $13.06 / $60.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.88 / $10.38 / $17.30
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.84 / $20.18 / $23.49
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.84 / $19.34 / $23.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.53 / $27.78 / $31.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.84 / $6.92 / $13.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.53 / $11.53 / $11.53