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South Dakota rates for HCPCS D0367

cone beam CT capture and interpretation with field of view of both jaws; with or without cranium

Facilitymedian $209 · 10th–90th $209–$3890%20%40%90th$209Professionalmedian $200 · 10th–90th $155–$2240%20%40%10th90th$200$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $199.53 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $338.84 / $407.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $1,071.52 / $1,071.52
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $302.00 / $478.63
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23