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South Dakota rates for HCPCS G0101

Cervical or vaginal cancer screening; pelvic and clinical breast examination

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.65 / $26.65 / $38.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.91 / $33.18 / $91.80
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$13.33 / $15.92 / $21.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.25 / $42.06 / $54.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.25 / $52.58 / $78.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.74 / $70.13 / $245.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.11 / $61.98 / $89.62
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.29 / $51.75 / $72.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.07 / $52.40 / $75.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.65 / $64.65 / $81.81
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.00 / $63.60 / $91.90