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South Dakota rates for HCPCS Q2004

Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml

Facilitymedian $102 · 10th–90th $102–$1200%50%90th$102Professionalmedian $102 · 10th–90th $17–$1200%20%40%10th90th$102$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $102.33 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $20.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $154.88 / $302.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $102.33 / $102.33
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $102.33 / $117.49
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33