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South Dakota rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $14.45 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $12.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $7.41 / $9.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $10.23 / $19.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $7.24 / $7.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.71 / $8.71 / $8.71
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $7.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.24 / $7.94
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24