go back

South Dakota rates for HCPCS A9581

Injection, gadoxetate disodium, 1 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $199.53 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.13 / $48.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $18.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $23.44 / $40.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $16.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $17.78 / $17.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $16.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $14.79