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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
$3,625.24 / $3,625.24 / $3,625.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,008.95 / $3,625.24 / $3,625.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,367.00 / $2,390.67 / $2,958.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,319.35 / $4,147.27 / $8,939.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,099.46 / $3,021.04 / $3,323.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,319.35 / $1,550.68 / $4,860.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,319.35 / $2,087.09 / $3,095.51
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,081.45 / $3,081.45 / $3,081.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,021.04 / $3,021.04 / $3,021.04
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,021.04 / $3,021.04 / $3,021.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,021.04 / $3,021.04 / $3,021.04