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South Carolina rates for HCPCS J1645

Injection Dalteparin Sodium Per 2500 Iu (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.37 / $17.37 / $76.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.97 / $17.37 / $27.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.86 / $22.30 / $27.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.81 / $16.54 / $32.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.60 / $15.60 / $16.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $16.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.59 / $19.11 / $43.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $16.54