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South Dakota rates for HCPCS J0275

Alprostadil urethral suppository (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.21 / $49.21 / $49.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.36 / $41.83 / $49.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.63 / $26.89 / $33.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.40 / $66.26 / $121.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.72 / $71.44 / $78.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.84 / $40.40 / $40.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.40 / $41.01 / $82.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.87 / $71.44 / $78.58