go back

South Dakota rates for HCPCS A9594

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$913.93 / $913.93 / $913.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.84 / $913.93 / $913.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.84 / $776.84 / $776.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$913.93 / $1,390.09 / $2,253.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$761.61 / $761.61 / $837.77
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,302.34 / $1,302.34 / $1,519.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$947.95 / $947.95 / $947.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.37 / $761.61 / $837.77
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.17 / $372.17 / $372.17