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South Dakota rates for HCPCS A9537

Technetium Tc-99m mebrofenin, diagnostic, per study dose, up to 15 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $173.78 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $56.23 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $87.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $100.00 / $169.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $63.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $93.33 / $93.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $64.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13