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South Dakota rates for HCPCS A9516

Iodine I-123 sodium iodide, diagnostic, per 100 mcCi, up to 999 mcCi

Facilitymedian $427 · 10th–90th $76$8320%20%10th90th$427Professionalmedian $115 · 10th–90th $107$2040%20%40%10th90th$115$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $426.58 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $125.89
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $204.17
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $194.98 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $107.15 / $117.49
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $144.54
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82