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South Dakota rates for HCPCS A9512

Technetium Tc-99m pertechnetate, diagnostic, per mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.02 / $2.02 / $280.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.02 / $2.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.50 / $25.50 / $31.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.02 / $3.09 / $14.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $1.93
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.25 / $18.68 / $29.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.25 / $20.67 / $34.61
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.29 / $1.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $1.86
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.26 / $1.26