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South Dakota rates for HCPCS C9064

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.19 / $269.86 / $333.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.54 / $272.54 / $272.54