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South Dakota rates for HCPCS 90997

Hemoperfusion

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.81 / $94.23 / $94.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.61 / $171.69 / $223.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.81 / $159.25 / $238.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.55 / $157.54 / $931.22
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.68 / $187.33 / $222.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.00 / $175.98 / $224.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.39 / $144.07 / $169.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.15 / $147.82 / $188.75
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.50 / $197.50 / $197.50