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South Dakota rates for HCPCS J1097

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

Facilitymedian $141 · 10th–90th $117–$1,7380%20%10th90th$141Professionalmedian $120 · 10th–90th $115–$1450%50%10th90th$120$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $812.83 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $120.23 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $144.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $181.97 / $346.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $117.49 / $117.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $134.90
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49