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South Dakota rates for HCPCS J1212

Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$748.85 / $748.85 / $748.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.85 / $748.85 / $898.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.21 / $748.84 / $910.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.12 / $1,062.34 / $2,035.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.72 / $742.90 / $817.19
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$664.10 / $891.47 / $1,251.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.70 / $815.54 / $1,073.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.63 / $819.49 / $819.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$715.39 / $748.85 / $823.74
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$742.90 / $742.90 / $742.90
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.90 / $742.90 / $742.90