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South Dakota rates for HCPCS J0744

Injection Ciprofloxacin For Intravenous Infusion 200 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.90 / $124.36 / $255.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.81 / $2.90 / $3.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.16 / $2.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.99 / $3.90 / $53.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.10 / $2.31 / $2.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.99 / $1.66 / $2.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.42 / $2.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.17 / $3.17 / $3.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $2.90 / $3.19
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $2.31
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.31 / $2.31 / $2.31