go back

South Dakota rates for HCPCS 91113

Gi Tract Imaging Intraluminal Colon I&R

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,034.96 / $1,034.96 / $1,034.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$917.09 / $917.09 / $1,034.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,476.04 / $1,818.73 / $2,273.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,108.60 / $1,549.88 / $1,881.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.30 / $2,011.60 / $5,839.98
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,251.31 / $1,667.67 / $2,150.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,244.90 / $1,251.31 / $1,943.20
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,187.42 / $1,449.14 / $1,734.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,160.17 / $1,805.24 / $2,123.81
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,610.20 / $1,894.30 / $1,970.10