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South Dakota rates for HCPCS 92975

Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.71 / $703.75 / $867.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.94 / $626.01 / $938.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.26 / $719.50 / $3,104.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.59 / $856.42 / $941.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.00 / $795.44 / $941.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.85 / $624.14 / $711.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.70 / $647.21 / $755.08
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$734.00 / $863.50 / $898.00