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South Dakota rates for HCPCS 86787

Antibody Varicella-Zoster

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.11 / $117.10 / $429.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.23 / $12.11 / $60.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.46 / $25.46 / $25.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.87 / $23.50 / $29.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.34 / $20.65 / $521.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.43 / $7.73 / $18.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.45 / $26.23 / $40.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.45 / $21.61 / $35.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.47 / $30.08 / $35.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.41 / $7.73 / $15.46
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $12.88