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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
$3.89 / $93.33 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $3.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $3.89 / $53.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.29 / $2.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $2.75 / $2.75
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $2.00 / $2.19
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.88 / $2.88 / $2.88