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South Dakota rates for HCPCS 80155

Caffeine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $43.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $30.20 / $45.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $74.13 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $74.13 / $91.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $43.65 / $181.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $38.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $89.13 / $107.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $19.50 / $38.90
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $38.90 / $38.90