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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
$8.41 / $8.41 / $8.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.67 / $8.41 / $9.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.90 / $4.88 / $4.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $5.52 / $10.58
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.84 / $3.86 / $8.41
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.94 / $4.63 / $4.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $4.45 / $5.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.19 / $9.19 / $9.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.41 / $8.41 / $9.25
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.86 / $3.86 / $3.86
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.86 / $3.86 / $3.86