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South Dakota rates for HCPCS J0200

Injection, alatrofloxacin mesylate, 100 mg

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $19.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.91 / $26.92 / $48.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $19.95 / $19.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $21.88