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South Dakota rates for HCPCS J1943

Injection, aripiprazole lauroxil, (Aristada Initio), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.25 / $3.25 / $3.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.25 / $3.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.23 / $3.24 / $4.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.76 / $4.66 / $8.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.14 / $3.26 / $3.59
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.76 / $3.91 / $5.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.57 / $3.77 / $7.60
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $3.55 / $3.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.25 / $4.13
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.26 / $3.26 / $3.26
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.26 / $3.26 / $3.26