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South Dakota rates for HCPCS 90658

Iiv3 Vaccine Split Virus 0.5 Ml Dosage Im Use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.07 / $22.07 / $22.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $22.07 / $26.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.28 / $22.28 / $27.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.37 / $31.56 / $60.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.09 / $21.69 / $22.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.70 / $23.02 / $26.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.18 / $24.92 / $32.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.86 / $22.07 / $26.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.69 / $21.69 / $22.28
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.07 / $22.07 / $22.07
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $22.07 / $22.07