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South Dakota rates for HCPCS 84446

Tocopherol alpha (Vitamin E)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.33 / $71.81 / $206.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.22 / $12.62 / $77.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.07 / $28.07 / $28.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.52 / $26.11 / $32.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.59 / $23.84 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $12.76 / $29.18
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.72 / $28.88 / $44.45
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.72 / $23.80 / $38.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.15 / $33.11 / $38.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.96 / $9.92 / $17.02
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.18 / $14.18 / $14.18