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South Dakota rates for HCPCS J2704

Injection, propofol, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.13 / $134.85 / $426.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.09 / $18.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.11 / $0.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $3.10 / $7.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.10
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.10 / $0.11 / $0.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.12 / $0.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.10
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09