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South Dakota rates for HCPCS J0691

Injection Lefamulin 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.82 / $0.82 / $0.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.82 / $0.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.82 / $1.06 / $2.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $0.91 / $1.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.91 / $1.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.70 / $0.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.92
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.68
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.68