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South Dakota rates for HCPCS J0200

Alatrofloxacin Mesylate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.04 / $20.04 / $20.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.63 / $20.04 / $20.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.38 / $15.53 / $19.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.92 / $26.98 / $49.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $20.04 / $22.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.17 / $21.17 / $31.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $20.04 / $22.04