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South Dakota rates for HCPCS 84590

Vitamin A

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.91 / $98.77 / $268.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.78 / $10.33 / $63.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.85 / $22.85 / $22.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.22 / $20.89 / $26.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.13 / $21.32 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.97 / $8.11 / $16.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.98 / $23.66 / $36.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.98 / $25.79 / $33.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.95 / $27.11 / $31.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.88 / $8.11 / $13.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.61 / $11.61 / $11.61