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South Dakota rates for HCPCS 96567

Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $158.49 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $288.40 / $363.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $223.87 / $1,621.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $234.42 / $269.15
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $223.87 / $257.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $239.88 / $302.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $199.53 / $239.88