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South Dakota rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Facilitymedian $20 · 10th–90th $20–$280%50%90th$20Professionalmedian $18 · 10th–90th $17–$220%20%10th90th$18$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $20.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $16.98 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $22.39
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $28.18 / $51.29
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $20.89 / $20.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $26.30