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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
$10.84 / $14.37 / $32.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.73 / $10.84 / $30.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.85 / $22.85 / $22.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.22 / $20.89 / $26.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.05 / $18.48 / $60.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $10.38 / $23.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.88 / $23.49 / $36.15
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.88 / $25.27 / $33.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.82 / $26.92 / $31.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.84 / $8.06 / $13.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.53 / $11.53 / $11.53