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South Dakota rates for HCPCS J0401

Inj Aripiprazole Ext Rel 1mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.28 / $7.28 / $4,274.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.34 / $8.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.16 / $7.28 / $8.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.15 / $10.35 / $19.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.03 / $7.24 / $7.96
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.74 / $8.68 / $12.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.74 / $8.14 / $10.61
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.96 / $7.96 / $7.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $8.01
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24