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South Dakota rates for HCPCS G0404

Electrocardiogram Routine Ecg With 12 Leads; Tracing Only Without

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.66 / $6.79 / $6.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.75 / $8.44 / $8.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.23 / $15.12 / $97.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.23 / $11.06 / $16.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.53 / $10.78 / $13.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.22 / $14.28 / $17.70
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.19 / $10.90 / $11.30