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South Dakota rates for HCPCS J1050

Injection, medroxyprogesterone acetate, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.65 / $0.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.68 / $120.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.19 / $0.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $0.84 / $1.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.54 / $0.59
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $0.69 / $0.82
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.69 / $0.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.48 / $0.48
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.26 / $0.26
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.26 / $0.26