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South Dakota rates for HCPCS J0716

Injection, Centruroides immune f(ab)2, up to 120 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,295.32 / $6,295.32 / $6,295.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,225.12 / $6,295.32 / $6,295.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,718.88 / $3,756.06 / $4,648.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,107.27 / $8,102.08 / $15,524.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,246.10 / $5,246.10 / $5,770.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,198.65 / $7,198.65 / $8,398.43
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,300.52 / $6,300.52 / $6,300.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,351.02 / $5,351.02 / $5,351.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,674.60 / $5,246.10 / $5,770.71
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,246.10 / $5,246.10 / $5,246.10
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,246.10 / $5,246.10 / $5,246.10