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South Dakota rates for HCPCS Q4213

Ascent, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $67.61 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $57.54 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $58.88 / $58.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $93.33 / $117.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $263.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $58.88 / $58.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $79.43
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $69.18 / $69.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $69.18