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South Dakota rates for HCPCS C9254

Injection Lacosamide

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.24 / $0.24 / $86.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.24 / $0.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.37 / $0.60
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.40 / $0.40
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20