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South Dakota rates for HCPCS A9586

Florbetapir F-18, diagnostic, per study dose, up to 10 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,428.88 / $3,428.88 / $3,428.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,845.96 / $2,914.55 / $3,428.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,914.55 / $2,914.55 / $4,900.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,428.88 / $4,412.97 / $8,455.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,857.40 / $2,857.40 / $3,257.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,821.26 / $4,543.26 / $5,636.21
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,821.26 / $4,498.64 / $8,359.41
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,914.55 / $2,914.55 / $2,914.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,857.40 / $2,857.40 / $3,143.14
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,857.40 / $2,857.40 / $2,857.40