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South Dakota rates for HCPCS J1265

DOPamine HCl IV SOLN 40 MG/ML

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $0.83 / $0.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.83 / $0.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $1.03 / $1.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $0.66 / $0.83
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $0.79 / $0.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.79 / $1.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.92 / $0.92 / $0.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.91
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $0.66 / $0.66
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $0.66 / $0.66