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South Dakota rates for HCPCS J2250

Injection, midazolam HCl, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.59 / $90.95 / $307.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.16 / $18.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.14 / $0.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $30.30 / $126.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.16 / $0.18
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.14 / $0.16 / $0.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.15 / $0.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $0.17 / $3.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.17
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.16 / $0.16 / $0.16
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.16 / $0.16 / $0.16