go back

South Dakota rates for HCPCS J0285

Amphotericin B

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.41 / $43.41 / $43.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.47 / $43.41 / $43.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.00 / $51.00 / $63.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.86 / $57.66 / $93.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.11 / $34.11 / $50.07
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.10 / $60.08 / $65.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.60 / $50.22 / $75.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.50 / $47.50 / $47.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.41 / $43.41 / $47.75
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.11 / $34.11 / $34.11
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.11 / $34.11 / $34.11