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South Dakota rates for HCPCS A9503

Technetium Tc 99m Medronate Diagnostic Per Study Dose Up To 30 Millicuries Special Coverage Instructions Apply. See Mcm: 1502

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.60 / $95.66 / $238.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.94 / $13.26 / $15.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.00 / $108.00 / $135.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.60 / $23.73 / $129.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $14.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.98 / $25.06 / $140.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.98 / $25.39 / $42.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.05 / $11.05 / $55.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $14.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00