go back

South Dakota rates for HCPCS J1095

Injection, dexamethasone 9%, intraocular, 1 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $1.38 / $1.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.17 / $1.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.17 / $1.17 / $1.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $1.77 / $3.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.14 / $1.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.38 / $1.38 / $1.38
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.17 / $1.17 / $1.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.14 / $1.27
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.14 / $1.14 / $1.14
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.14 / $1.14