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South Dakota rates for HCPCS 0013M

Oncology (urothelial), mRNA, gene expression profiling by real-time quantitative PCR of five genes (MDK, HOXA13, CDC2 [CDK1], IGFBP5, and CXCR2), utilizing urine, algorithm reported as a risk score for having recurrent urothelial carcinoma

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $575.44 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $1,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $1,380.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $457.09 / $3,801.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,778.28 / $2,089.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $457.09 / $870.96
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58