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South Dakota rates for HCPCS 88323

Consltj&Reprt Referred Matrl Requiring Prepj Sld

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.92 / $331.20 / $365.40
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.09 / $213.30 / $227.84
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$18.82 / $18.82 / $18.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.53 / $206.50 / $307.56
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$98.00 / $150.21 / $227.60
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$39.65 / $52.40 / $79.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.18 / $211.77 / $745.14
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.29 / $134.81 / $538.00
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$15.89 / $73.89 / $340.13
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$217.63 / $217.63 / $217.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.00 / $206.55 / $250.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.84 / $213.88 / $247.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$106.94 / $141.87 / $166.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.41 / $58.22 / $102.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.90 / $70.18 / $262.12
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.13 / $54.29 / $180.02
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$15.89 / $17.77 / $82.10
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.40 / $254.10 / $273.20
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$146.40 / $188.40 / $202.50
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.10 / $65.70 / $70.70