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South Dakota rates for HCPCS 96522

Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.06 / $122.84 / $139.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.01 / $236.59 / $295.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.20 / $205.73 / $779.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.44 / $222.86 / $281.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.30 / $185.66 / $216.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.38 / $205.73 / $252.11
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.20 / $258.39 / $258.39