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South Dakota rates for HCPCS A9528

Iodine I-131 Sodium Iodide Capsule(S) Diagnostic Per Millicurie

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.56 / $67.56 / $67.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.56 / $67.56 / $68.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.00 / $111.00 / $138.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.30 / $114.99 / $186.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.66 / $52.69 / $105.38
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.57 / $158.96 / $224.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.57 / $161.06 / $265.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.66 / $57.47 / $105.38