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South Dakota rates for HCPCS J1652

Fondaparinux Sodium

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $1.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $1.22 / $4.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.86
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $1.03 / $2.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $1.20 / $4.67
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.79
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.72
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.72