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South Dakota rates for HCPCS 95874

Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$21.13 / $21.13 / $21.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.50 / $77.95 / $185.40
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.07 / $19.32 / $30.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.47 / $155.63 / $194.54
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.72 / $39.47 / $48.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.41 / $143.25 / $516.91
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.02 / $35.67 / $122.01
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.23 / $142.76 / $207.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.28 / $119.75 / $143.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.87 / $32.34 / $36.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.41 / $133.44 / $168.53
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.89 / $35.67 / $41.96
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.80 / $179.60 / $179.60
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.00 / $46.50 / $46.50