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South Dakota rates for HCPCS J0780

Prochlorperazine Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.88 / $68.78 / $163.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $5.71 / $26.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.96 / $2.99 / $3.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.52 / $4.26 / $9.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.81 / $125.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.84 / $7.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $3.54 / $14.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.98 / $1.98 / $1.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $1.81 / $2.15
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.52 / $2.52 / $2.52
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.52 / $2.52