go back

South Dakota rates for HCPCS J1744

Injection, icatibant, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.92 / $83.92 / $83.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.65 / $83.92 / $151.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.93 / $69.93 / $69.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.69 / $127.69 / $159.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.45 / $127.65 / $488.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.93 / $69.93 / $125.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.38 / $202.59 / $236.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.38 / $150.38 / $162.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.82 / $360.06 / $360.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.67 / $46.67 / $95.99
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.67 / $46.67 / $46.67
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.67 / $46.67 / $46.67