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South Dakota rates for HCPCS J0360

Injection, hydralazine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.60 / $68.44 / $610.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.24 / $5.60 / $6.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $5.58 / $5.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.12 / $14.22 / $65.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.40 / $5.19 / $5.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.95 / $5.28 / $6.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $4.70 / $7.67
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.12 / $6.12 / $6.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.60 / $5.60 / $6.16
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.19 / $5.19 / $5.19
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.19 / $5.19 / $5.19