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South Dakota rates for HCPCS J1631

Injection, haloperidol decanoate, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.02 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.98 / $30.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $3.98 / $5.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.61 / $7.94 / $33.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $4.68 / $4.68
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.62 / $5.62 / $5.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $4.37 / $4.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $3.98 / $7.41
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.37 / $4.37 / $4.37