go back

South Dakota rates for HCPCS J1560

Injection, gamma globulin, intramuscular, over 10 cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.48 / $170.48 / $170.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.73 / $170.48 / $202.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.70 / $173.70 / $173.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.08 / $498.08 / $622.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.90 / $415.99 / $593.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.06 / $167.06 / $415.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.47 / $593.00 / $864.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.38 / $563.35 / $741.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.56 / $186.56 / $484.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.48 / $170.48 / $187.53
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.06 / $167.06 / $167.06
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.06 / $167.06 / $167.06