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South Dakota rates for HCPCS J1240

Dimenhydrinate Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.14 / $6.14 / $76.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.82 / $9.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.51 / $10.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.41 / $13.08 / $21.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.58 / $7.74 / $8.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.94 / $9.91 / $10.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.27 / $9.82 / $13.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.72 / $6.72 / $6.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.14 / $6.55
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.74 / $7.74 / $7.74
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.74 / $7.74 / $7.74