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South Dakota rates for HCPCS Q9969

Tc-99m from nonhighly enriched uranium source, full cost recovery add-on, per study dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.94 / $18.61 / $25.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $2.49 / $2.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.88 / $10.88 / $13.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.56 / $4.21 / $8.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.02 / $12.02
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00