go back

South Dakota rates for HCPCS J0133

Injection, acyclovir, 5 mg

Facilitymedian $0 · 10th–90th $0$00%20%40%90th$0Professionalmedian $0 · 10th–90th $0$00%20%10th90th$0$0.0$0.1$0.1$0.2$0.5$1.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.11 / $0.14
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.06 / $0.14
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.04
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.12 / $0.13
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.12