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South Dakota rates for HCPCS J1245

Injection, dipyridamole, per 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $16.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $14.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.51 / $10.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $5.50 / $10.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.31 / $3.89 / $8.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $4.68 / $4.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $9.12 / $9.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $8.32 / $9.33
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.32 / $8.32 / $8.32