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South Dakota rates for HCPCS 82415

Chloramphenicol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.91 / $11.91 / $11.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.49 / $11.91 / $11.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.46 / $25.46 / $25.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.46 / $22.85 / $28.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.14 / $20.30 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.60 / $11.40 / $26.07
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.68 / $25.82 / $39.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.68 / $21.27 / $34.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.69 / $29.59 / $34.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $8.86 / $15.20
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.67 / $12.67 / $12.67