go back

South Dakota rates for HCPCS J1990

Chlordiazepoxide Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.31 / $26.31 / $26.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.84 / $26.31 / $26.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.75 / $21.75 / $27.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.06 / $35.43 / $64.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.05 / $21.05 / $23.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.06 / $25.81 / $38.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.20 / $33.75 / $51.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.05 / $21.05 / $23.16