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South Dakota rates for HCPCS 80159

Clozapine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.94 / $18.94 / $18.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.50 / $18.94 / $100.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.47 / $40.47 / $40.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.13 / $36.56 / $45.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.30 / $29.65 / $95.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.09 / $18.14 / $38.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.01 / $37.68 / $51.85
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.01 / $41.10 / $52.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $48.55 / $55.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.46 / $12.94 / $24.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.14 / $20.14 / $20.14