go back

South Dakota rates for HCPCS J0770

Colistimethate Sodium Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.06 / $13.06 / $13.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.50 / $13.06 / $13.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.19 / $13.06 / $15.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.59 / $19.25 / $31.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.39 / $11.39 / $13.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.67 / $14.59 / $21.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.86 / $14.33 / $21.53
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.29 / $14.29 / $14.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.06 / $13.06 / $16.05
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.39 / $11.39 / $11.39
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.39 / $11.39 / $11.39