go back

Swallowed Capsule Camera Bowel Exam

South Dakota rates for HCPCS 91110

This test uses a small swallowable capsule containing a camera that takes pictures as it travels through the esophagus, stomach, and small intestine. The images are transmitted to a recorder worn by the patient and later reviewed by a doctor to look for sources of bleeding, inflammation, or other abnormalities in areas that are hard to reach with a standard scope.

Facilitymedian $120 · 10th–90th $120$1200%50%$120Professionalmedian $759 · 10th–90th $162$1,6220%5%10%10th90th$759$100.0$200.0$500.0$1.0K$2.0K$5.0K

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$954.99
Typical High
$1,621.81
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$107.15
Median
$186.21
Typical High
$691.83
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$537.03
Median
$758.58
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,548.82
Typical High
$1,905.46
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$234.42
Median
$234.42
Typical High
$295.12
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$1,288.25
Median
$1,288.25
Typical High
$1,621.81
Medica
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,548.82
Typical High
$5,370.32
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$154.88
Median
$245.47
Typical High
$1,047.13
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$776.25
Median
$1,348.96
Typical High
$4,466.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,778.28
Typical High
$1,995.26
Midlands
Setting
Professional
Modifier
26 · Professional part
Typical Low
$257.04
Median
$275.42
Typical High
$288.40
Midlands
Setting
Professional
Modifier
TC · Technical part
Typical Low
$1,412.54
Median
$1,479.11
Typical High
$1,698.24
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$1,778.28
Typical High
$1,778.28
Midlands
Setting
Professional
Modifier
26 · Professional part
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Midlands
Setting
Professional
Modifier
TC · Technical part
Typical Low
$1,479.11
Median
$1,479.11
Typical High
$1,479.11
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,174.90
Typical High
$1,479.11
Sanford Health Plan
Setting
Professional
Modifier
26 · Professional part
Typical Low
$141.25
Median
$213.80
Typical High
$316.23
Sanford Health Plan
Setting
Professional
Modifier
TC · Technical part
Typical Low
$831.76
Median
$1,071.52
Typical High
$1,230.27
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,513.56
Typical High
$1,995.26
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$141.25
Median
$234.42
Typical High
$331.13
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$776.25
Median
$1,288.25
Typical High
$1,659.59
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,548.82
Typical High
$1,621.81
Wellmark
Setting
Professional
Modifier
26 · Professional part
Typical Low
$208.93
Median
$245.47
Typical High
$257.04
Wellmark
Setting
Professional
Modifier
TC · Technical part
Typical Low
$1,096.48
Median
$1,318.26
Typical High
$1,348.96