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South Dakota rates for HCPCS B4083

Stomach tube - Levine type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $3.24 / $7.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $2.14 / $3.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $2.95 / $2.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.24 / $2.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $2.14 / $3.80