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South Dakota rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.82 / $42.48 / $50.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.58 / $43.58 / $54.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.37 / $69.97 / $113.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.40 / $41.40 / $45.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.54 / $51.32 / $75.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.54 / $49.74 / $64.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.48 / $46.48 / $46.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $46.73
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.40 / $41.40 / $41.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.40 / $41.40 / $41.40