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South Dakota rates for HCPCS J1630

Injection, haloperidol, up to 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $1.94 / $107.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $1.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.80 / $0.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.20 / $1.45 / $77.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.87 / $0.94
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $1.04 / $1.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.38 / $2.31
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $0.88 / $0.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $1.60
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.84 / $0.84 / $0.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.84 / $0.84