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South Dakota rates for HCPCS G0659

Drug Test(S) Definitive Utilizing Drug Identification Methods Able To Identify Individualdrugs And Distinguish Between Structural Isomers Including But Not Limited To Gc/Ms And Lc/Ms Performed W/O Method Or Drug-Specific Calibration W/O Matrix-Matched Quality Control Material Or W/O Use Of Stable Isotope Or Other Universally Recognized Internal Standard(S) For Each Drug Drug Metabolite Or Drug Class Per Specimen; Quali-Tative Or Quantitative Per Day Any Number

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.41 / $58.41 / $58.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.63 / $58.41 / $58.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.88 / $64.88 / $81.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.64 / $70.34 / $295.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.28 / $55.93 / $119.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.41 / $83.89 / $107.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.41 / $105.97 / $162.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.14 / $149.71 / $170.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.10 / $40.70 / $74.56
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.14 / $62.14 / $62.14