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South Dakota rates for HCPCS 90586

Bacillus Calmette-Guerin vaccine (BCG) for bladder cancer, live, for intravesical use

Facilitymedian $162 · 10th–90th $162–$1620%50%$162Professionalmedian $162 · 10th–90th $162–$2090%50%90th$162$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $426.58
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $177.83 / $177.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $199.53
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18