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South Dakota rates for HCPCS 95939

Ctr Motr Ep Std Transcrnl Motr Stim Upr&Low Li

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$126.87 / $126.87 / $126.87
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$348.98 / $453.71 / $755.37
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$756.14 / $931.70 / $1,164.61
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$391.87 / $777.78 / $2,779.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$138.46 / $191.37 / $225.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$467.70 / $629.88 / $844.85
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$427.78 / $777.78 / $974.84
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$871.40 / $1,066.20 / $1,066.20