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South Dakota rates for HCPCS J2993

Injection, reteplase, 18.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $3,630.78 / $3,630.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.03 / $3,090.30 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,951.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $4,168.69 / $8,912.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $3,019.95 / $3,019.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $1,862.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,090.30 / $3,090.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.03 / $3,019.95 / $3,311.31
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,019.95