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South Dakota rates for HCPCS A9590

Iodine I-131, iobenguane, 1 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$384.47 / $384.47 / $384.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.58 / $326.80 / $384.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.39 / $326.80 / $400.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$384.47 / $539.29 / $692.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.39 / $320.39 / $1,460.99
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.32 / $594.32 / $594.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.74 / $384.74 / $384.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.77 / $326.77 / $326.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.39 / $320.39 / $365.25
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.36 / $320.36 / $320.36