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South Dakota rates for HCPCS 87350

Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; hepatitis Be antigen (HBeAg)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $35.48 / $36.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $10.47 / $30.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $21.88 / $27.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $17.78 / $50.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $8.13 / $16.22
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $27.54 / $31.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $8.13 / $19.95
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $11.48 / $11.48