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South Dakota rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Facilitymedian $26 · 10th–90th $20–$510%50%10th90th$26Professionalmedian $26 · 10th–90th $25–$320%50%10th90th$26$20.0$50.0

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
$25.12 / $25.12 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $28.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $32.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $28.84 / $47.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $17.38 / $19.95
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $20.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $25.70 / $29.51
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $25.70