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South Dakota rates for HCPCS 87420

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; respiratory syncytial virus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.08 / $13.08 / $13.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.10 / $12.34 / $20.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.42 / $27.42 / $27.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.11 / $25.46 / $31.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.33 / $19.22 / $83.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.35 / $12.52 / $24.66
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.95 / $25.50 / $43.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.95 / $26.63 / $36.31
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.73 / $32.47 / $38.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.84 / $12.52 / $18.36
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.91 / $13.91 / $13.91