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South Dakota rates for HCPCS J1885

Injection, ketorolac tromethamine, per 15 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.32 / $67.20 / $148.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $1.40 / $14.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $54.94 / $152.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.35 / $0.50
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.42 / $0.90 / $1.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.70 / $1.02
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $2.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.33
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35