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South Dakota rates for HCPCS 86304

Immunoassay Tumor Antigen Quantitative Ca 125

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.81 / $124.64 / $477.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.64 / $18.87 / $113.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.78 / $41.78 / $41.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.95 / $37.86 / $47.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.93 / $33.36 / $256.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.49 / $14.56 / $29.07
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.85 / $42.42 / $65.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.85 / $46.00 / $59.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.97 / $48.59 / $57.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.74 / $14.56 / $24.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.81 / $20.81 / $20.81