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South Dakota rates for HCPCS Q9964

High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.51 / $0.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.56 / $0.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.43
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.14 / $1.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.43