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South Dakota rates for HCPCS 80197

Tacrolimus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $109.65 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $12.59 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $26.30 / $26.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $26.30 / $32.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.18 / $21.88 / $257.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $9.55 / $19.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $35.48 / $38.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $9.55 / $23.99
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.80 / $13.80 / $13.80