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South Dakota rates for HCPCS A9556

Gallium Ga-67 citrate, diagnostic, per mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $138.04 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $26.30 / $32.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $208.93 / $398.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $154.88 / $154.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $37.15 / $37.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $169.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90