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South Dakota rates for HCPCS J0745

Injection, codeine phosphate, per 30 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.15 / $1.45 / $2.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.51 / $1.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.62 / $1.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.70