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South Dakota rates for HCPCS A9517

Iodine I-131 sodium iodide capsule(s), therapeutic, per mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.59 / $2,073.60 / $10,841.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.56 / $39.11 / $68.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.38 / $49.22 / $88.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.84 / $87.19 / $137.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.84 / $42.84 / $664.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.36 / $98.50 / $297.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.12 / $81.52 / $187.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.84 / $42.84 / $47.12
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.13 / $23.13 / $23.13
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.13 / $23.13 / $23.13