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South Dakota rates for HCPCS 96913

Photochemotherapy (Goeckerman and/or PUVA) for severe photoresponsive dermatoses requiring at least 4-8 hours of care under direct supervision of the physician (includes application of medication and dressings)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $173.78 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $169.82 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $331.13 / $416.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $218.78 / $346.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $239.88 / $977.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $288.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $257.04
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $218.78 / $295.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $239.88 / $346.74
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $275.42