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South Dakota rates for HCPCS J2550

Injection, promethazine HCl, up to 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $2.95 / $2.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.90 / $2.97 / $3.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.38 / $3.38 / $4.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.76 / $4.28 / $7.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.87 / $3.19 / $3.68
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.44 / $3.98 / $4.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $3.87 / $5.35
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.49 / $3.22 / $3.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $2.95 / $3.28
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.87 / $2.87 / $2.87
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.87 / $2.87 / $2.87