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South Dakota rates for HCPCS 92014

Oph Svcs Medical Xm&Eval Compre Est Pt 1/>Vst

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $62.00 / $133.93
Aetna
Facility/Professional
Facility
Modifier
25
Low / Median / High Price
$121.58 / $121.58 / $135.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.84 / $124.67 / $181.90
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$71.33 / $126.48 / $141.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.34 / $157.18 / $274.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.27 / $120.18 / $217.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.95 / $184.10 / $476.78
Medica
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$106.55 / $187.74 / $250.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.66 / $239.50 / $309.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.34 / $191.43 / $287.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.55 / $154.07 / $241.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.36 / $144.12 / $229.31
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.40 / $168.10 / $282.00