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South Dakota rates for HCPCS J1952

Leuprolide injectable, camcevi, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.92 / $78.92 / $78.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.21 / $79.70 / $99.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.36 / $53.90 / $66.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.52 / $86.88 / $140.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.41 / $57.23 / $78.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.69 / $83.87 / $97.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.69 / $64.37 / $106.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.36 / $86.36 / $86.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.92 / $78.92 / $87.85
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.41 / $51.41 / $51.41
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.41 / $51.41 / $51.41