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South Dakota rates for HCPCS J0735

Injection Clonidine Hydrochloride 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.17 / $18.67 / $213.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.17 / $18.35 / $21.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.50 / $18.17 / $20.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.44 / $29.86 / $265.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.20 / $17.67 / $19.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.59 / $20.09 / $37.34
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.53 / $21.21 / $37.34
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.88 / $19.88 / $19.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.17 / $18.17 / $19.98
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.67 / $17.67 / $17.67
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.67 / $17.67 / $17.67