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South Dakota rates for HCPCS G0104

Colorectal cancer screening; flexible sigmoidoscopy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.39 / $191.80 / $191.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.89 / $141.96 / $354.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.70 / $260.38 / $359.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.48 / $211.04 / $354.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,643.00 / $1,643.00 / $1,643.00