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South Dakota rates for HCPCS 87633

Iadna Respiratry Probe & Rev Trnscr 12-25 Target

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.91 / $391.77 / $765.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.08 / $486.97 / $625.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$830.88 / $830.88 / $830.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$585.88 / $757.05 / $946.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.31 / $559.02 / $765.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.07 / $291.58 / $857.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.84 / $913.41 / $1,168.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.14 / $849.13 / $1,168.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.62 / $1,004.15 / $1,144.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.05 / $291.58 / $416.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.78 / $416.78 / $416.78