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South Dakota rates for HCPCS J0780

Injection, prochlorperazine, up to 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $47.86 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.63 / $22.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.57 / $2.57 / $3.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.51 / $4.27 / $38.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.51 / $2.82 / $125.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.47 / $3.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $7.76 / $7.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $2.75 / $2.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.51 / $2.82 / $3.02
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $1.82 / $1.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.82 / $1.82