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South Dakota rates for HCPCS 80158

Cyclosporine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.97 / $16.97 / $16.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.09 / $16.97 / $16.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.90 / $35.90 / $35.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.65 / $32.64 / $40.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.29 / $28.95 / $137.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.83 / $16.25 / $37.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.30 / $36.78 / $56.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.30 / $40.00 / $51.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.48 / $42.15 / $49.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.58 / $16.25 / $23.83
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.05 / $18.05 / $18.05