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South Dakota rates for HCPCS 84207

Pyridoxal phosphate (Vitamin B-6)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $107.15 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $25.70 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $53.70 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $53.70 / $67.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $56.23 / $138.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $19.50 / $38.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $67.61 / $77.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $19.50 / $48.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.18 / $28.18