go back

South Dakota rates for HCPCS J0575

Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.62 / $18.62 / $18.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.90 / $15.83 / $18.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.88 / $17.04 / $21.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.73 / $28.32 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.73 / $18.50 / $20.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.21 / $15.21 / $15.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.32 / $15.32 / $15.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.28 / $17.30 / $19.04
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.06 / $7.06 / $7.06
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.06 / $7.06 / $7.06