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South Dakota rates for HCPCS J0400

Injection, aripiprazole, intramuscular, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.36 / $0.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.47 / $1.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.86 / $0.95
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.42 / $0.62
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.57 / $0.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $0.95