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South Dakota rates for HCPCS A9503

Technetium Tc-99m medronate, diagnostic, per study dose, up to 30 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $117.49 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $15.14 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $107.15 / $134.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $20.89 / $128.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $14.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $10.96 / $10.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $14.79
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $12.88