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South Dakota rates for HCPCS 84425

Thiamine (Vitamin B-1)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.84 / $103.76 / $302.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.55 / $18.89 / $94.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.43 / $42.43 / $42.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.37 / $38.52 / $48.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.32 / $38.96 / $101.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.57 / $19.11 / $25.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.40 / $43.26 / $66.56
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.21 / $43.26 / $58.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.15 / $49.57 / $58.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.57 / $12.74 / $21.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.23 / $21.23 / $21.23