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South Dakota rates for HCPCS A9548

Indium In-111 pentetate, diagnostic, per 0.5 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,071.52 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $912.01 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,380.38 / $2,630.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $891.25 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $295.12 / $295.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $977.24
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25