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South Dakota rates for HCPCS 86052

Aquaporin-4 (neuromyelitis optica [NMO]) antibody; cell-based immunofluorescence assay (CBA), each

Facilitymedian $14 · 10th–90th $11–$5500%20%10th90th$14Professionalmedian $11 · 10th–90th $8–$280%20%10th90th$11$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $13.80 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $10.96 / $10.96
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $18.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $22.91 / $28.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $13.49 / $60.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $14.45
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $28.18 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.24 / $15.85
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $12.02