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South Dakota rates for HCPCS G0071

Payment for communication technology-based services for 5 minutes or more of a virtual (nonface-to-face) communication between a Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC) practitioner and RHC or FQHC patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an RHC or FQHC practitioner, occurring in lieu of an office visit; RHC or FQHC only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $23.44 / $23.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.80 / $18.76 / $23.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.13 / $20.16 / $20.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.80 / $20.48 / $39.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.76 / $37.77 / $148.97
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.25 / $21.50 / $42.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.25 / $29.73 / $42.97
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.11 / $23.72 / $38.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.12 / $26.64 / $46.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.30 / $21.00 / $21.00