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South Dakota rates for HCPCS J1652

Injection, fondaparinux sodium, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.78 / $1.78 / $4.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.51 / $2.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $0.89 / $1.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $1.23 / $4.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.85
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.85 / $0.85
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $0.95 / $0.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.87 / $0.98
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.72