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South Dakota rates for HCPCS 86480

Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $229.09 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $57.54 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $120.23 / $147.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $100.00 / $269.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $43.65 / $87.10
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $147.91 / $169.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $43.65 / $107.15
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66