go back

South Dakota rates for HCPCS J1626

Injection, granisetron HCl, 100 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $24.07 / $104.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.26 / $0.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.23 / $0.39 / $10.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $4.12 / $155.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.34 / $0.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.39 / $0.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $10.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $4.12
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.23 / $0.23 / $0.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.23 / $0.23