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South Dakota rates for HCPCS A9579

Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.48 / $130.10 / $566.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.48 / $1.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.54 / $1.54 / $1.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.48 / $4.03 / $27.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.47 / $1.62
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.77 / $1.93 / $2.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.95 / $4.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.61 / $1.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.48 / $1.63
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.47 / $1.47