go back

South Dakota rates for HCPCS G0279

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$28.65 / $28.65 / $28.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.14 / $65.86 / $76.54
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.89 / $38.49 / $73.80
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$54.11 / $54.11 / $54.11
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$19.30 / $36.22 / $64.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.50 / $50.00 / $61.88
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.50 / $31.82 / $39.38
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$18.00 / $18.18 / $22.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.69 / $99.45 / $334.42
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.99 / $55.48 / $182.49
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.85 / $46.73 / $151.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.05 / $86.55 / $144.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.66 / $81.13 / $98.02
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.90 / $49.13 / $54.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.40 / $30.40 / $42.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.72 / $89.10 / $116.95
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.54 / $48.34 / $60.42
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$23.17 / $38.22 / $50.96
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.30 / $95.70 / $95.70
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.40 / $61.60 / $61.60
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.00 / $34.10 / $34.10