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South Dakota rates for HCPCS J1201

Injection, cetirizine HCl, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $16.98 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $16.98 / $28.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $21.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $23.44 / $44.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.80 / $16.22 / $16.60
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $19.50
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $18.62 / $18.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $16.98 / $18.62
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $16.60 / $16.60