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South Dakota rates for HCPCS J2440

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $45.00 / $45.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $41.83 / $47.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $1.88 / $1.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.11 / $51.48 / $110.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $37.50 / $41.25
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.11 / $3.33 / $4.92
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $4.36 / $7.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $38.25 / $38.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $37.50 / $41.25
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.86 / $38.86 / $38.86
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.86 / $38.86 / $38.86