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South Dakota rates for HCPCS A9562

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.48 / $588.04 / $813.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.48 / $771.67 / $848.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.38 / $860.90 / $1,065.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$811.04 / $935.25 / $1,516.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$883.24 / $883.24 / $971.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$988.73 / $1,175.85 / $1,823.61
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$988.73 / $1,175.85 / $2,040.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$883.24 / $883.24 / $971.56
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.67 / $662.67 / $662.67