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South Dakota rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Facilitymedian $309 · 10th–90th $309–$3980%50%90th$309Professionalmedian $269 · 10th–90th $251–$3980%20%40%10th90th$269$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $309.03 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $257.04 / $309.03
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $316.23 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $398.11 / $758.58
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $257.04 / $288.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $263.03 / $302.00
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04