go back

South Dakota rates for HCPCS J2360

Injection Orphenadrine Citrate Up To 60 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.19 / $71.43 / $286.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.53 / $11.30 / $12.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.56 / $12.56 / $15.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.59 / $15.97 / $162.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.44 / $9.44 / $12.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.84 / $11.34 / $16.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.84 / $7.28 / $17.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.24 / $12.24 / $12.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.19 / $11.19 / $12.31
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.44 / $9.44 / $9.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.44 / $9.44 / $9.44