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South Dakota rates for HCPCS 86684

Antibody; Haemophilus influenza

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $18.20 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $14.13 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $30.20 / $38.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $24.55 / $74.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $10.00 / $22.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $38.02 / $43.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $10.00 / $27.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $15.85