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South Dakota rates for HCPCS 80200

Tobramycin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $18.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $15.14 / $43.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $30.90 / $38.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $25.12 / $66.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $11.22 / $22.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $38.90 / $44.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $11.22 / $27.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.22