go back

South Dakota rates for HCPCS J2358

Injection, olanzapine, long-acting, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.92 / $2.92 / $2.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.92 / $2.92 / $3.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.96 / $2.96 / $3.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $4.91 / $8.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.92 / $2.92 / $3.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.50 / $3.50 / $5.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.30 / $3.50 / $4.38
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.19 / $3.19 / $3.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.92 / $2.92 / $3.36
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.92 / $2.92 / $2.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.92 / $2.92 / $2.92