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South Dakota rates for HCPCS 0163U

Oncology (colorectal) screening, biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1, Cripto-1], carcinoembryonic antigen [CEA], extracellular matrix protein [ECM]), with demographic data (age, gender, CRC-screening compliance) using a proprietary algorithm and reported as likelihood of CRC or advanced adenomas

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $363.08 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $302.00 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $741.31 / $933.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $446.68 / $1,862.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $199.53 / $467.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $912.01 / $1,071.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $234.42 / $512.86
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $389.05