go back

South Dakota rates for HCPCS 88377

M/Phmtrc Alys Ish Quant/Semiq Mnl Each Multiprb

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.13 / $299.13 / $299.13
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.81 / $48.81 / $171.77
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$250.32 / $250.32 / $927.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.41 / $677.14 / $1,041.32
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.48 / $110.33 / $164.33
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$434.93 / $568.26 / $876.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.52 / $389.08 / $2,575.76
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.22 / $119.38 / $393.91
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$206.30 / $274.41 / $2,181.85
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$220.05 / $220.05 / $220.05
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.01 / $677.14 / $797.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.06 / $639.53 / $752.34
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$78.52 / $106.10 / $120.97
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$237.38 / $536.70 / $631.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.87 / $246.52 / $818.68
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.95 / $40.22 / $132.63
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$199.92 / $206.30 / $686.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$659.90 / $849.00 / $913.00
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$106.10 / $136.50 / $146.80
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$553.79 / $712.50 / $766.20