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South Dakota rates for HCPCS 87495

Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $28.18 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $57.54 / $72.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $33.88 / $58.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $18.20 / $208.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $61.66 / $83.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.59 / $18.20 / $34.67
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20