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South Dakota rates for HCPCS 90715

Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.61 / $145.08 / $201.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.63 / $44.84 / $73.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.83 / $49.78 / $49.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.05 / $89.26 / $162.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $53.96 / $53.96
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.11 / $36.11 / $52.18
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.11 / $38.46 / $52.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $43.57 / $43.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $53.96 / $55.43
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.71 / $39.71 / $39.71
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.71 / $39.71 / $39.71