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South Dakota rates for HCPCS A9593

Gallium Ga-68 PSMA-11, diagnostic, (UCSF), 1 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.43 / $933.43 / $933.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.42 / $933.43 / $933.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.42 / $793.42 / $793.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.43 / $1,419.75 / $2,301.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.86 / $777.86 / $855.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,330.14 / $1,330.14 / $1,551.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$968.17 / $968.17 / $968.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.86 / $777.86 / $855.65
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.91 / $534.91 / $534.91